Residents are unionizing at Mass General Brigham. Here's what you need to know

The doctors in training at Mass General Brigham, which has one of the largest residency programs in the country, have voted to unionize.

Seventy-five percent of the trainees who voted — or 1,215 people — supported unionizing, hospital and union officials said Thursday.

It's the latest in a string of victories for the Committee of Interns and Residents, an affiliate of the Service Employees International Union (SEIU), which has been adding members at hospitals across the country.

"It's a referendum on the structure of medical training and our compensation and our ability to negotiate what we want to see — not only with our employers, but in health care delivery," said Dr. Sarah Brown, a first-year internal medicine resident at Massachusetts General Hospital.

The new bargaining unit will represent about 2,500 resident physicians and fellows across several of the system's hospitals, including Mass General, Brigham and Women’s, Faulkner, Newton-Wellesley, Salem, McLean, Spaulding and Mass Eye and Ear.

Here’s what you need to know.

Why resident physicians are unionizing

Residents and fellows are doctors who have completed medical school but still need to complete several years of training before practicing independently. Their schedules can be grueling, with 60- or 80-hour work weeks. Residents say they also stepped up during the pandemic when hospitals struggled with other staffing shortages.

The doctors leading the call for unionization say they need better pay, benefits and working conditions to accommodate their tough schedules, and to help them afford the cost of living in Boston. They argue a union will give them a seat at the table to advocate for themselves and for improving patient care.

Around the country, Brown said, "We're seeing residents and fellows be able to advocate for themselves and gain benefits and salary and patient care initiatives that we would have never had the power to win before unionization started to become more common."

The key bargaining issues

Through contract negotiations, other bargaining units have won benefits such as meal stipends, housing stipends, reimbursement for using a ride-hailing app to get home after long shifts and enhanced fertility benefits, said Annie Della Fera, a spokesperson for the union.

At Mass General Brigham, residents plan to negotiate for help paying for housing and child care in Boston, where costs are among the highest in the country.

"The sticker shock on Boston rent was incredible," said Dr. Lee Richman, a first-year pathology resident at Brigham and Women’s Hospital.

"I had half the space for twice the money," said Richman, who came from Philadelphia. "That was a real struggle."

Residents say unionizing can have an impact on patient care, too. Through contract negotiations, they hope to establish a fund to buy medical equipment that helps them provide care.

Even before the union vote, the trainees scored a victory. Mass General Brigham committed to 10% salary increases and $10,000 stipends for all residents and fellows. Hospital leaders said the raises came after a review of compensation across the entire workforce.

How Mass General Brigham is responding

Mass General Brigham is the state’s biggest and most powerful hospital system. In the days and weeks leading up to the vote, hospital leaders urged residents in emails and video messages to vote against the union.

They argued that collective bargaining is "naturally antagonistic” and would standardize training programs instead of allowing for flexibility that helps trainees.

After the votes were counted Thursday, hospital leaders said they were disappointed by the results of the election.

"Moving forward, our mission remains unchanged," Dr. Paul Anderson, interim chief academic officer, said in a statement. "We will continue to deliver on our promise of providing a world-class medical education experience, working within the parameters that will be established by the collective bargaining process."

The national context

The Committee of Interns and Residents represents 27,500 doctors in training across the country, and it’s growing rapidly — by more than 10,000 members in the past two years.

Over the past year, nine residency programs with a total of more than 7,000 residents and fellows joined the union. They include Montefiore Medical Center, Stanford Health Care, George Washington University and University of Pennsylvania.

"This is a national trend," Richman said. "I think it’s a response to the modern health care system, and I think it's going to keep happening."

A few other Massachusetts medical training programs already have unionized residents, including Boston Medical Center, Cambridge Health Alliance and UMass Chan Medical School.

What happens next

The election results must be certified by the National Labor Relations Board. Then union leaders will start polling members on their concerns and take those issues to the bargaining table. The process of negotiating an initial contract can take several months, or as long as a year.

"We're super excited," Richman said. "We want to be at the table. We want to negotiate in good faith."