Motivations and Drivers of Unionization Among General Surgery Residents

Introduction: Residency program unionization has grown in recent years, yet little data exists to explain the trend. Thus, the objective of this study was to explore general surgery residents’ motivations towards unionization (reasons, feelings, etc.). Methods: Six programs that had unionized since 2019 were identified using purposive sampling, with attention to diversity in geography and duration of union contract. Semi-structured interviews were conducted with residents from these programs. Interviews were recorded, transcribed, and thematically analyzed using inductive logic. Emergent themes were identified by dyads of independent coders, applying constant comparative approach to reach consensus. Results: Across 24 interviews, four main themes were identified regarding unionization. First was resident dissatisfaction with their employment contract, with many living “paycheck to paycheck” while others required “state assistance for childcare”. Second, residents “feel like they’re being exploited” for the wages they receive, as “[residents are] worth a lot of money in terms of the skill that we bring to the hospital”. Third, unions provided a mechanism for self-advocacy in a system with a lack of single responsible agent for change advocacy. With authority and liability belonging to an interwoven system of institutions, accrediting bodies, and healthcare organizations, “without a union, you have very little way to improve your working conditions or bargain for increased pay,” while unionization “gives [residents] a collective voice to have some power to be treated well.” Fourth, residents unsupportive of unions were concerned a union was not the best means of change, rather than disagreement on systemic problems. Conclusion: Residents pursue unionization in response to mounting financial constraints, feelings of exploitation, and constrained mechanisms for meaningful self-advocacy in a complex health system. Defining the interaction of macro- and individual-level factors residents experience is necessary to understand the trainee unionization phenomenon and delineate systemic adaptations that may be warranted.

Author dc:creator

• Maya Louise Hunt (24399356)

• Health Sciences, Medicine and Surgery
• Sociology, Industrial and Labor Relations

Statement dc:rights

• In Copyright

DOI dc:identifier

https://doi.org/10.25417/uic.32993744.v1

OAI identifier oai:identifier

oai:figshare.com:article/32993744