At the nation’s largest academic medical centers, resident physicians have rekindled a long-standing debate over health care worker unionization. According to the Committee of Interns and Residents, the number of unionization wins increased from one in 2020 to two in 2021 to five in 2022. This year alone, residents have voted in favor of unionization in landslide elections at Penn Medicine in Philadelphia (88 percent), Mass General Brigham in Boston (75 percent), Montefiore Medical Center in New York (82 percent), and George Washington University Hospital in Washington, DC (94 percent).

As unionization efforts have spread, they have renewed debate over the role of resident labor in hospitals, the rights of trainee-workers, the ethics of health care worker strike actions, and the financial priorities of C-suite executives in the modern hospital.

One of the major points of contention is what effect unionization will have on the most important people in any hospital: the patients. In this debate, supporters and detractors alike have tried to draw lessons from other health care worker unions. Opponents of unionization, on the other hand, accuse nursing unions of seeking to impose inflexible mandates that frustrates efforts to provide care in unavoidably fluid circumstances.