Resident Unions Are Growing in Popularity in Otolaryngology

Organizing Forces

Michael J. Ruckenstein, MD, MSc, an otorhinolaryngologist and director of residency training and education at the Hospital of the University of Pennsylvania in Philadelphia, believes that while otolaryngology residents were generally in favor of unionization, the process last spring was driven primarily by residents in programs larger than otolaryngology, such as internal medicine, anesthesia, and pediatrics.

“Many of them were quite heavily put upon during the COVID-19 crisis and perhaps didn’t feel heard or didn’t feel there was a mechanism by which they could make themselves heard,” he said. “I think that’s a lot of what drove the process, because one thing a contract does is provide a stipulated pathway to launch a grievance and have an advocate there for you at the table to help address it.” 

Dr. Ruckenstein didn’t think the hardships of the pandemic impacted otolaryngology residents as much as other specialties but rather that they were sympathetic to their colleagues.

Residents at the University of California, San Francisco School of Medicine (UCSF) have been enjoying union benefits since 2017 and are now paid more; additionally, their meal stipends are significantly higher than at other medical schools, and being unionized has generally been helpful for residency recruiting, said Steven D. Pletcher, MD, director of the residency program in the department of otolaryngology–head and neck surgery.

While Dr. Pletcher was not involved with union negotiations, he recalls that money was the biggest issue, along with parking, resident lounges, and available and affordable food. (As far as hours worked, resident unions at UCSF have not impacted that issue beyond the Accreditation Council for Graduate Medical Education (ACGME) requirements that max out at 80 hours per week and stipulate no more than 24 hours of continuous scheduled clinical assignments).

“In some ways it makes my job easier,” said Dr. Pletcher. “When residents come to me and say, ‘We really need help with parking,’ or ‘We really need these other issues solved,’ I can tell them to speak to their union representative.”

UCSF otolaryngology resident Jacqueline Harris, MD, said that programs with unions were toward the top of her rank list. After a union representative came to speak at her residency orientation, she became a union representative herself. “In my first year of residency, my class started the year with a new contract that had just been bargained for and won by the union,” she said. “It detailed all of the new additions to our contracts that would enhance our day-to-day experiences, and I felt grateful for the changes that had been fought for.”