Should residents unionize? Hear the pros and cons at virtual Clinical Congress 2020 RAS-ACS Symposium

The annual Resident and Associate Society (RAS) Symposium at the American College of Surgeons (ACS) Clinical Congress provides a venue for members of the RAS to discuss the pros and cons of an important topic related to residency, hosted by the RAS Advocacy and Issues Committee. For this year’s virtual Clinical Congress 2020, the topic of discussion is on resident unionization.

The August issue of the Bulletin of the American College of Surgeons typically publishes essays from Resident Members on the symposium topic; however, the shifting publication schedule due to COVID-19 made running this series of essays impossible in 2020. For now, read on to view the initial paragraphs of the introductory essay on resident unionization, “Resident unionization: Future of resident advocacy or deterioration of a profession?” authored by Julia R. Coleman, MD, MPH; Navin Vigneshwar, MD; K. Benjamin Lee, MD; Brett M. Tracy, MD; Brett Starr, MD; Kate Stadeli, MD; and Randi Ryan, MD.

The full essay will be published in the January 2021 issue of the Bulletin. Also be sure to view the RAS Symposium Panel Session, either live or on-demand once it is available on the conference website (registration and log-in information required). Visit the Clinical Congress 2020 website for more information and a link to access the conference once it opens.

Resident unionization: Future of resident advocacy or deterioration of a profession?

Medical school debt, work-life balance, wellness, and salaries discordant with cost of living—these issues are only a few of the complex stressors surgical residents face. The Accreditation Council for Graduate Medical Education (ACGME) requires all residency programs to maintain a house staff association to advocate for residents; however, many trainees feel that these groups are inadequately positioned to effect change. For several institutions across the country, these circumstances have eventuated in resident unionization, giving trainees the authority to tackle sensitive and contemporary nodi.*

The concept of resident unionization is controversial. Proponents of resident unionization report an increase in the recognition of their voice, enhanced communication with hospital administration, and more effective advocacy efforts, whereas physicians who are opposed to resident unionization cite concerns that unions usurp energy and resources from house staff associations or other existing leadership structures; distract residents from clinical and educational duties; and create a confrontational, adversarial culture.

Now more than ever before and in light of the ongoing COVID-19 pandemic, thousands of residents across the country considering advocacy issues, ranging from hazard pay and loan forgiveness to workplace safety, have reignited the debate about the role of resident unionization. To address these questions and to discuss important, pressing issues in resident training, the RAS-ACS Advocacy and Issues Committee hosts the annual RAS Symposium at the ACS Clinical Congress. Each year, the symposium organizes a panel to discuss a current issue that affects surgeons and surgical trainees. This year, the 2020 RAS Symposium will explore the widespread opinions on resident unionization.


*Sklar D, Chang B, Hoffman BD. Commentary: Experience with resident unions at one institution and implications for the future of practicing physicians. Academic Medicine. 2011;86(5):552-554.

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