Many radiology program directors see resident unions as 'problematic'
Though trainees may have legitimate reasons to organize, imaging leaders believe the move could pose harm for both programs and residents themselves.
According to survey results published this week in Academic Radiology, the majority of radiology program directors do not believe the drawbacks of unionizing outweigh potential benefits. Although many indicated they empathize with residents’ petitions for more favorable compensation, most agreed unionizing may ultimately set residents back in their education and careers.
“While unionizing can improve working conditions, employee benefits and resident well-being, there have also been concerns raised about the potential harm to the student-educator relationship, to patient outcomes and to professionalism,” Priscilla J. Slanetz, MD, MPH, with the department of radiology at Boston University Chobanian & Avedisian School of Medicine, and co-authors noted. “Opponents argue that the Accreditation Council for Graduate Medical Education (ACGME) already requires residency programs to establish formal procedures whereby house staff can register complaints and recommendations and that this may offer a better avenue for advocacy. Other administrators have expressed the position that contracts should be negotiated within their institution, arguing that outside involvement is not necessary at all.”
Residents’ call for unionization has grown increasingly louder in the wake of the COVID-19 pandemic, when hospital staff were overworked and exposed to immensely challenging working conditions. While most in the field find the call for change to be relatable, residency program directors have witnessed the evolution of medical training post-COVID from a different perspective. To get a better idea of how these directors believe unions affect education, experts recently distributed a 24-question survey to members of the Association for Program Directors in Radiology (APDR).
Of the respondents, 71% indicated they work with trainees who have not yet unionized. Nearly 80% of directors said they felt unions make their job more difficult. More specifically, 71% said unions interfere with their ability to remediate a struggling resident, while another 70% indicated unions change the way directors carry out their roles. Just under 60% expressed concerns with how unions could negatively impact the trainee-faculty relationship, with others cautioning that unions may hinder residents’ willingness to accept constructive feedback.
“One respondent specifically stated that unions would ‘increase friction and decrease long-term stability.' Additionally, multiple comments mentioned a financial concern that house staff unions could be ‘cost-prohibitive’, particularly for ‘resource-limited state hospitals’ and may result in fewer available residency spots,” the authors noted.
Despite this, 65% said they understood how unions could benefit residents by enabling them to have their voices heard and improving their benefits, and another 57% said they felt unions could help residents increase their compensation.
Though obvious patterns in opinions were identified in the responses, the authors acknowledged their results do not offer a clear answer whether unions are the solution to residents’ criticisms.
“Many participants expressed mixed opinions, stating that unions could benefit some residents (such as those from smaller programs without robust GME oversight) or programs where resident compensation and benefits vary significantly based on specialty or hospital,” the authors wrote. “However, they stopped short of offering a wholehearted endorsement of unionization across all programs. Others commented that at this time, they are unsure of what the effects of unions will be and that it is ‘too early to tell.’”
In addition to her background in journalism, Hannah also has patient-facing experience in clinical settings, having spent more than 12 years working as a registered rad tech. She began covering the medical imaging industry for Innovate Healthcare in 2021.