As doctors, we love our programs and care deeply about our patients’ health and well-being. For decades, interns, residents and fellows all across the country have organized in order to negotiate for better housestaff salaries and working conditions as well as to enhance the quality of patient care. Those of us who have joined the Committee of Interns and Residents (CIR) have found that forming a union is the best way to have an effective voice at work and develop solutions to issues and problems at our hospitals.
By joining CIR, the largest housestaff union in the country, we can negotiate directly with the hospital administration and make lasting improvements for ourselves and our patients.
Every hospital’s problems are different, and every contract is negotiated locally by the residents to address your hospital-specific concerns. Some issues that CIR has successfully fought for at the bargaining table for other hospitals include:
- Inadequate pay compared to rising cost of living
- Competitive and reasonable benefits
- Insufficient or unsatisfactory on-call rooms
- Lack of safety on the job
- Inadequate meals while on care
- Inadequate book and conference funds
- Insufficient or outdated equipment for patient care
CIR members also use our union as a platform to speak out on issues of patient care, access to health care and addressing the needs of underserved populations, offering our unique perspective from the front-lines of the health care system.
The Committee of Interns and Residents is the largest housestaff union in the country, representing more than 13,000 residents in California, Florida, Massachusetts, New Jersey, New Mexico, New York, and Washington, D.C.. Since 1957, interns and residents in over 60 hospitals have joined CIR and formed collective bargaining units to negotiate contracts that improve housestaff salaries and working conditions, as well as enhance the quality of patient care.
CIR is governed by an Executive Committee consisting of interns and residents who have been elected by their peers from across the country.
A union contract is a legally binding document between the housestaff and the hospital administration. It will contain provisions that we, the housestaff, decide to negotiate for.
CIR contracts at various institutions are different from each other and must be voted on by the housestaff at each facility in order to be approved.
For some specific examples, read “What’s in a CIR contract?”
While there may be some initial tension during the organizing process, our experiences at other hospitals show that relationships between housestaff and the administration can grow stronger as we work together toward common goals. Administration and housestaff share many similar objectives, including improving ancillary staff, enhancing discharge planning, improving care for patients, and assuring adequate financial support for the hospital.
There are no provisions in CIR contracts that dictate how your program educates you, and you should not expect changes in that regard.
Any contract the housestaff negotiates with the administration would create a standardized process to resolve housestaff grievances. Having a strong housestaff union and a legally binding union contract establishes an effective process for resolving problems when the normal, informal channels are not working. The union contract ensures that each resident is assured prompt, fair and equitable resolution to disputes.
Not at all. Contracts are designed to raise basic standards for all residents. But the purpose of doing so is to increase the options available to residents, not to decrease flexibility. Any contract that we negotiate would absolutely preserve the flexibility that individual programs have to award extra benefits. If a department wishes to provide a benefit to its residents that we cannot win for all residents, they are free to continue to provide that benefit.
No. Strikes are becoming increasingly uncommon for resident unions. In fact, an overwhelming majority of all union contracts that are negotiated occur without a strike.
It is also important to note that all decisions about what actions to take (or not to take) are made solely and independently by the local CIR chapter, made up exclusively of you – the interns, residents and fellows at your hospital. Over the last 50 years, CIR residents have developed a wide range of effective strategies and tactics that have enabled residents to win hundreds of fair contracts and resolve disputes without striking.
Yes. Many residents and fellows choose to form a housestaff union at their hospital precisely because unionization and having a voice in our workplace improves patient care. While it is difficult for us as individuals to exert much influence over administrative or governmental decision-making, collectively we can have much more of an impact.
Moreover, being part of a national organization like CIR which is actively fighting to improve patient care and access to health care provides us with resources that can help us more effectively advocate for our patients.
Dues are used to help fund a full-time staff and office for our chapter, as well as a national office with a team of lawyers and professional staff who work to maintain high standards and quality services for all members of CIR. CIR’s staff works full-time to:
- Help enforce and uphold current CIR contracts
- Organize new members into CIR in order to grow and strengthen our union
- Advocate for issues in the public and private sector that concern residents on a national and local level
As CIR members, we pay 1.5% of our salary in dues. This rate is set by an elected representative body of residents at our annual convention.
No housestaff pay dues until the contract is bargained for, negotiated and won, and then voted upon by a majority vote of all housestaff. Every initial contract that CIR negotiated has included benefits and salary increases that have far exceeded the cost of dues.
Contact the national CIR office at (212) 356-8100 or continue exploring this Web site.