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May 09, 2023

Penn Medicine residents and fellows vote to unionize, becoming the state's first hospital house staff union

Most of the roughly 1,400 doctors employed at the university voted for representation; workers have accused the school of union busting

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Penn Medicine Union Thom Carroll/For PhillyVoice

Penn Medicine's resident physicians and fellows voted to unionize, becoming the first hospital house staff union in Pennsylvania. 88% of about 1,400 workers voted to form the union with the Committee of Interns and Residents.

Penn Medicine resident physicians and fellows have voted overwhelmingly to unionize in support of higher pay, better medical benefits and improved working conditions at one of the top-rated hospitals in the region. 

On Monday, 88% of the roughly 1,400 residents and fellows voted to approve the unionization measure, joining the Committee of Residents and Interns in an effort to fight for their first contract with the University of Pennsylvania Health System. The union, which represents more than 25,000 residents and fellows nationwide, said that Penn Medicine's doctors are the eighth group to join the union in the last 11 months.

Though it will take up to seven days for the vote results to be certified by the National Labor Relations Board, Penn Medicine's resident union is the first of its kind in Pennsylvania. The state does not have any other unionized residency programs. 

Residents say their efforts began at the beginning of the COVID-19 pandemic, when house staffers were told that they would not receive a regular cost-of-living increase. They spent several months working with hospital management to improve working conditions, ultimately deciding to unionize. 

Earlier this year, hundreds of workers sought voluntary recognition of the union from the University of Pennsylvania Health System, but the university failed to accept the demands for voluntary recognition, The Daily Pennsylvanian reported. Once the unionization vote is certified, the union will begin to negotiate their first contract with the health system. 

"At the end of the day, the prestige of working at a nationally ranked hospital like Penn isn't enough to ensure our patients receive top quality care, to meet our basic needs or to address the deeper inequities of our healthcare system," said Dr. Madison Sharp, a third-year OB/GYN resident. "Winning representation is a huge step toward addressing these issues and raising care standards for all of us." 

The residents said they are often expected to pick up extra shifts with no additional pay and that they routinely work 80 hours per week, a number that has become standard in teaching hospitals since 2003. Additionally, a lack of pay raises and parking benefits helped grow support for unionizing, the Inquirer reported in February. 

First-year residents at Penn Medicine can expect to earn $69,869 per year beginning in July, when the program's pay scale is adjusted. In their ninth year of post-graduate work, Penn Medicine residents will earn $94,404. Residents are offered health benefits and malpractice insurance, as well as up to four weeks of vacation time and 12 weeks of family leave. 

Medical students often enter the job market with up to $200,000 in student loan debt, which the American Medical Association said "looms large" as doctors leave training and enter practice. 

Residents have also cited unionizing as a way to help advance medical equity in West Philadelphia communities and elsewhere in the city, which faces the highest disease burden in the state, according to a 2019 report from Drexel University.

"We chose to train at an academically rigorous and highly-respected institution, but we expect more from Penn than just a fancy name," said Dr. Chantal Tapé, a third-year resident in family medicine. "We are human beings first and foremost. If we're sacrificing our physical and mental health, our financial stability, and our personal relationships in order to provide care, that means our health care system is failing." 

After going public with their unionization effort earlier this year, residents and fellows said that they have endured months of anti-union campaigning from Penn. In emails and photos of signs posted to the Committee of Interns and Residents' Instagram account, Penn Medicine allegedly urged residents and fellows to vote no or not vote at all on the unionization effort. 

The union has already filed one unfair labor practice charge against the university for their conduct leading up the union election this month, according to the NLRB. 

In an emailed statement, a Penn Medicine spokesperson said, "We respect our trainees' collective decision and remain committed to continuing our work to improve their training experience and ensure that they are fully supported during these transformative years of their medical careers." 

"We are proud of Penn Medicine's long history as home to many top residency and fellowship programs, and we have appreciated the ongoing opportunity to hear directly from residents about their concerns during this unionization campaign. We have an obligation to stay true to our shared goals to provide the very best care to our patients, and to ensure that new physicians are able to train in an environment that allows them resources to flourish academically, professionally, and personally." 

Penn Medicine's unionization effort comes as workers across multiple industries in the region seek union representation and engage in collective bargaining with major employers. Last year, unionized workers at the Philadelphia Museum of Art went on strike for 19 days after contract negotiations stalled with museum management. 

Earlier this year, graduate students and other faculty staff unions at Temple University and Rutgers University went on strike for better pay and improved working conditions, often clashing with university administration. At Rutgers, Gov. Phil Murphy stepped in to mediate a conversation between union leaders and the university's president, eventually working to suspend the work stoppage and come to an agreement, which was ratified earlier this week. 

Staff at Eastern State Penitentiary and the Please Touch Museum have also voted to unionize in recent months, joining a growing collection of workers fighting for representation and a chance to bargain for higher salaries, health care access and protection from harassment. 

"Penn residents and fellows have made history as the first housestaff in Pennsylvania to unionize, changing the landscape of what's possible," said Sen. Nikil Saval, a Democrat from Philly. "I am proud to welcome them into Philly's indomitable union family, and I will be standing with them as they fight for their first contract. Protecting the health and wellbeing of these workers is crucial to ensuring all Philadelphians receive the world class healthcare that Penn is famous for, and that everyone deserves."