Medical residents and fellows at the School of Medicine and Health Sciences voted overwhelmingly to unionize Thursday.
SMHS residents and fellows voted 253-16 Wednesday and Thursday join the Committee of Interns and Residents — a subsidiary unit of the Service Employees International Union. Maryssa Miller, a physician who helped organize the unionization effort, said the union will form a bargaining committee in the coming weeks representing residents’ departments like internal medicine, emergency medicine, and obstetrics and gynecology.
Every year some group of physicians organizes to form a union. Most often they are not successful. The reasons are many.
George Washington University School of Medicine and Health Sciences is no worse than any other academic center.
1. Trainees have a limited time span 1-3 years in a position where they are subject to abuse.
2. A moral and ethical imperative to care for a patient, no matter the circumstance in hospital.
Always a point of contention is the long hours and difficulties for physician trainees.
COVID-19 exacerbated the intense work and long hours for all caregivers, including physicians.
Physicians' Unions have rarely gained strength in the United States. Perhaps the worst working conditions exist in academic settings.
Trainees are in a captive and at times abusive environment. This has been a never-ending story. Forty years ago when I was a trainee it was even worse. At times I would work 36-hour shifts. Today in 2023 Academic residency programs are required to abide by rules regarding training hours, limiting the work week to no more than 80 hours.
Medical residents and fellows at the School of Medicine and Health Sciences voted overwhelmingly to unionize Thursday.
SMHS residents and fellows voted 253-16 Wednesday and Thursday to join the Committee of Interns and Residents — a subsidiary unit of the Service Employees International Union. Maryssa Miller, a physician who helped organize the unionization effort, said the union will form a bargaining committee in the coming weeks representing residents’ departments like internal medicine, emergency medicine, and obstetrics and gynecology.
A recent report from the American Council for Graduate Medical Education reveals that despite the rules many institutions are being cited for infractions.
Some specialties were cited more often, Internal Medicine, Family Practice Transitional year (Internship). It is common practice for trainees in the initial year of training to be expected to carry a disproportionate workload. The reasons are a subordinate position as related to superiors, and the necessity to acquiesce to unreasonable demands to ensure being advanced to the next level of training.
What is the ACGME 16-hour rule?
In July 2011, the Accreditation Council for Graduate Medical Education (ACGME) reduced the consecutive number of hours that post-graduate year-1 residents can work in a single shift, from 30 to 16. This rule was intended to improve patient safety by reducing residents' fatigue.
It has been over ten years since this guideline was recommended by the ACGME. Ongoing examination reveals there has been considerable resistance to the ACGME guidelines.
Why is this?
The demands of clinical care are ongoing, 24/7/365/. It is a bit like 7-11. The relative shortage of physicians creates an undeniable demand for those working in the system. There is no reasonable solution for this confounding fact. The result would be a lack of physicians for a considerable portion of patients in the hospital. Can you imagine a patient needing emergency surgery at night and there would be no surgeon available?
Pros of Unionization
Unions provide an integrated and time-proven methodology of negotiations between employees and employers by an experienced third party
Cons
A Union introduces factors and dues whether you decided or not that prospective union members may not have factored into their voting.
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