Impacts of resident physician unionization on house staff compensation

• Published in: PloS one 2024-10, Vol.19 (10), p.e0308100
• Main Authors: Tyagi, Sidharth, Shah, Rema J, Huttler, Joshua, Kayani, Jehanzeb, Ghovanloo, Mohammad-Reza, Effraim, Philip R
• Format: Article
• Language: English
• Subjects: Collective bargaining; Compensation; Compensation and benefits; Cost of living adjustments; Cross-Sectional Studies; Earth Sciences; Handbooks; Health economics; Humans; Internal medicine; Internal Medicine - economics; Internal Medicine - education; Internship and Residency - economics; Investigations; Labor Unions; Medical education; Medical residencies; Medicine; Medicine and Health Sciences; Organizing; People and Places; Physicians; Physicians - economics; Research and Analysis Methods; Residents (Medicine); Salaries and Fringe Benefits - statistics & numerical data; Social aspects; Social Sciences; Training; Unionization; United States; Vacations; Wages & salaries; Working hours
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0308100

Physicians-in-training in the United States work long hours for relatively low wages. In response to increased economic burden, the popularity of unionization in residency training programs has increased dramatically. In this study, we conducted a cross-sectional investigation of the association between unionization status and Internal Medicine PGY-1 compensation and benefits. We compiled residency salary and benefits data from all Internal Medicine residency training programs in the United States. Using a mixed effects modeling approach, we evaluated the differences in salary and total compensation while adjusting for regional factors and cost-of-living differences. In aggregate, PGY-1 salary was higher for unionized vs. non-unionized programs ($69648 vs. $62214; [95% CI 670.7-3563.7]). However, there was no difference after adjusting for cost-of-living ($62515 vs $62475; [95% CI. -1317.5, 1299.7]). Unionized programs do however offer greater monetary benefits in the form of stipend disbursements, and total compensation is higher in unionized vs. non-unionized residency programs ($65887 vs $63515; [95% CI 607.6, 3551.5]). Unionized residency programs offer higher total compensation packages than their non-unionized counterparts. This increase in compensation is driven in large part by an increased variety and amount of stipend disbursement.