In hopes of gaining power and pay, resident doctors at a growing number of Chicago-area hospitals are joining unions.
Thousands of Chicago-area residents and fellows voted to unionize last year — at the University of Chicago Medicine in May, Northwestern Medicine in January, and West Suburban Medical Center in Oak Park in November. University of Illinois at Chicago residents and fellows to unionize in 2021.
Residents have long had to work long hours for relatively low pay, as they train to become certain types of doctors after medical school. Traditionally, residents have been expected to put their heads down and grind, for years, while gaining on-the-job experience and progressing toward more lucrative and prominent careers.
But that attitude is changing, residents say, amid changes in health care, frustrations stemming from the pandemic and growing unionization in many industries.
“Hospitals depend on us, but we have not been able to count on them to ensure fair working conditions,” said Dr. Anis Adnani, chief resident in the emergency medicine residency program at the University of Illinois at Chicago. “At some point, we decided to stand on our own and demand fair working conditions not only for ourselves, but also for what we see every day in terms of patient care.”
Before the union at the University of Illinois at Chicago landed its first contract last year, first-year residents were paid just under $60,000 a year for an average of 80 hours of work per week — an income equivalent to… Minimum wages. Al-Adnani said if it was divided every hour. He added that under the contract, residents were able to receive an 18.5% raise over four years and form a committee focused on the well-being of residents, among other gains.
“Any entity that relies heavily on a pool of labor for its operation must ensure good care of its workforce,” Al-Adnani said.
Residents at Northwestern, UMedicine and West Suburban have yet to reach contracts with their hospitals, having recently unionized.
They say they were inspired to join the unions in part because of the success of the Islamic Courts Union and other institutions across the country.
Overall, unions have seen growth across various industries in recent years and enjoy strong support. About 67% of Americans surveyed in 2023 said they approved of labor unions, up from a long-term average of 62%, according to Gallup — an environment that has helped residents unionize to thrive.
The Committee of Trainees and Residents — which represents doctors at Northwestern, UIC and UMedicine — has seen its membership nearly double to more than 33,000 doctors nationwide since 2020. The committee is part of the Service Employees International Union and also represents doctors in California and Massachusetts. New Jersey and New York, among other places.
“There has been a huge improvement,” said Dr. Philip Sosenheimer, a palliative medicine fellow at Stanford Health Care who was on the organizing committee for the Stanford unionization campaign.
In the past, doctors at East Coast hospitals were more likely to join unions than those in other areas of the country, and it was more common at public sector hospitals, he said. For example, residents at Stroger Hospital in Chicago, a public hospital, joined a union affiliated with a different group, the National Union of Hospital and Healthcare Employees, in 1974. The union in West Suburban is now part of the same group.
Now, residents at a growing number of large academic medical centers across the country are getting in on the action, including Illinois, which has more union-friendly laws.
“There's been an appetite for this for a long time,” Sosenheimer said. “(The older doctors) all talked about the similar dissatisfaction they felt in their day, but I think there are some things that have changed.”
First, most of the population is no longer white men with wives at home. About 48% of active U.S. residents earning MDs in 2022 were white, and about 48% of residents and fellows were women in 2022, according to the Association of American Medical Colleges.
He said residents are concerned about benefits such as paternity leave, or freezing their eggs if they want to have children after their stay, which can sometimes last up to seven years.
There have also been disruptions when it comes to the healthcare business. In the past, doctors often practiced independently. In recent decades, that has changed. In 2022, about 47% of doctors worked in private practice, compared with about 60% a decade ago, according to the American Medical Association — a change that stems from the economic, administrative and regulatory burdens that doctors in private practice can face, according to the association.
“The generation before us as doctors didn't think of unionization as a thing because they weren't employees,” Sosenheimer said. “They owned their own practices. This has changed radically in the last 15 years.”
This new reality means that doctors must now deal with employers who keep an eye on their bottom lines and are often involved in mergers and acquisitions. They feel more uncertain about their future.
“What's changed is that these trainees are starting to think of themselves as employees… and that long-term medical career may take longer to get,” said Robert Bruno, a professor of labor and employment relations at the University of Illinois at Urbana. Champagne. “The industry is changing, and they may find themselves in a different position in the job market.”
Residents also say COVID-19 was a catalyst for organizing. Residents say it has been a stressful time for all healthcare workers and, for many residents, has highlighted their lack of power and status in their organisations.
“With COVID, when residents were certainly on the front lines in many places, they realized how little protection they had as residents,” said Dr. Mugda Mokashi, who is completing her second year of residency at Northwestern Memorial Hospital.
One of the main reasons Mokashi, a member of her union's negotiating committee, wanted to join the union was to give residents more power when it comes to how the hospital operates. As a Northwestern resident, Mukashi spends half her time at Northwestern Memorial and the other half at Stroger.
“We care for patients with the least amount of support, with the least amount of resources, and yet, we also have the smallest voice in how the health care system works,” Mokashi said. “We have no say in how the department's finances are allocated. I believe the people on the front lines should have an active voice in how and why funds are allocated.”
Vanessa Vandroff, a third-year resident at the University of Chicago Medicine, said she wanted to unionize not because she hates her workplace, but because she cares deeply about it. She said residents want energy to help improve their hospitals.
The University of Chicago Medical Center said in a statement that it “remains committed to continuing to foster an exceptional learning and care environment for our 1,040 residents and fellows.”
VanDruff believes the unions at UChicago Medicine, Northwestern, UIC and West Suburban are just the beginning.
“I think the Residents Union will spread to almost every institution,” Vandruff said. “I think this is important.”
