1360 Faculty and Resident Perspectives on Collective Bargaining Efforts by Resident Physicians in the United States

INTRODUCTION: Employees across industries, including healthcare workers such as nurses, are frequently represented by collective bargaining unions. In recent years, resident physicians have been increasingly seeking unionization to improve working conditions and benefits. Whether resident unionization will benefit or harm neurosurgery training remains unclear. METHODS: A 17-question survey (14 multiple-choice, 3 open-ended) evaluating respondents’ opinions on resident unionization was emailed to 551 faculty members of the Society of Neurosurgeons and 1,728 neurosurgical trainees in the United States. Categorical variables were analyzed using Chi-squared tests. RESULTS: There were 405 respondents (response rate of 17.8%): 182 faculty (33.0%) and 223 trainees (12.9%). Among faculty respondents, 70% opposed or strongly opposed unions, 54% thought they negatively impact patient care, 80% thought they could lead to strikes, and 85% thought alternate channels for voicing resident concerns were adequate. In contrast, among trainees, only 16% opposed or strongly opposed unions, 9% thought they negatively impact patient care, 27% thought they could lead to strikes, and 47% thought alternate channels for voicing resident concerns were adequate (all p<.001). Among institutions with resident unions, 34.2% of faculty and 12.1% of trainees indicated witnessing a negative consequence of unionization, frequently mentioning lack of educational interests and inability to make departmental changes without applying changes to all resident specialties. Among unionized residents, 84.8% reported a positive consequence of unionization, including improved pay, protected working hours, parental leave, parking, and educational stipends. CONCLUSIONS: The findings revealed a divide between trainee and faculty perceptions of resident unionization. Faculty generally opposed unionization, while residents supported it. These results highlight an unmet need of resident representation and collective bargaining. Perceptions of the consequences of unionization appear to be conflicting, with negative expectations predominant for faculty.