My Housestaff Are Unionizing--Now What?: A Multi-Institutional Primer on Navigating the Union Process

Housestaff unionization efforts in GME training programs are rapidly increasing with nine residency programs representing over 7,000 residents and fellows unionizing in just the past year. The previously slow pace of housestaff unionization accelerated after the COVID-19 pandemic, during which increased work demands emphasized long-standing housestaff concerns over duty hours, burnout, compensation, and benefits. Few resources exist for residency program leadership on the standard process of unionization, leaving many programs to "learn on the fly" after their housestaff petition the National Labor Relations Board. In addition, program leadership occupy a unique position throughout the unionization process. As advocates for their housestaff, they are often positioned separately from hospital and GME leadership who may take varied stances on the unionization effort, which can often lead to uncertainty over program leadership role in this process and potential confusion on engagement with house staff, union representatives, and hospital leadership. This workshop will allow participants to hear the first-hand experience from four residency programs whose housestaff who are in various stages of unionization. Participants will gain insight into the unique impact of the unionization process on residency program operations. The presenters will share practices for navigating difficult conversations between hospital leadership and house staff as well as describe limits on program changes during contract negotiations. Finally, presenters will highlight opportunities for program growth and innovation post-unionization. Participants will have an opportunity to discuss their own program experiences with unionization.