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Thousands of resident physicians in Philadelphia voted to unionize this month

Here’s a primer on how the vote was decided at area health systems — and what’s next for resident unions in Philadelphia.

Resident and fellow physicians at Temple University Hospital joined thousands of other doctors-in-training around the Philadelphia area in voting to unionize in January.
Resident and fellow physicians at Temple University Hospital joined thousands of other doctors-in-training around the Philadelphia area in voting to unionize in January.Read moreTyger Williams / Staff Photographer

Eight in 10 doctors-in-training in Philadelphia are now represented by unions, following a wave of labor organizing across major health systems in the region.

Doctors at three Philadelphia health systems and Delaware’s largest health provider voted to join the Committee of Interns and Residents, a division of the Service Employees International Union.

The move follows a national trend of physicians unionizing around the country, as doctors increasingly look for solutions to burnout in a field now dominated by large health system employers. This is especially true among medical residents who work up to 80-hour weeks for relatively little pay, often making about $61,000 a year, less than other professions requiring specialized training.

Here’s a primer on how the votes were decided — and what’s next for resident unions in Philadelphia.

How did medical residents vote at each health system?

After residents at several area health systems announced plans to unionize in November, doctors-in-training at Children’s Hospital of Philadelphia were the first to hold a vote. In late December, they opted against unionizing, with 178 votes for a union and 195 against — a 17-vote margin.

Among the health systems whose residents began union drives last year, CHOP was the only health system to vote against joining a union. Here’s a tally of how other health systems voted:

  1. Jefferson Health: 552-73 in favor of a union

  2. Nemours Children’s Hospital, whose residents are affiliated with Jefferson: 69-5 in favor

  3. Einstein Healthcare Network, which is owned by Jefferson: 356-35 in favor

  4. Temple University Hospital: 425-11 in favor

  5. Temple Health - Chestnut Hill Hospital: 27-3 in favor

  6. Fox Chase Cancer Center, which is owned by Temple: 29-8 in favor

  7. ChristianaCare: 111-52 in favor

Are there other unionized physicians in the Philadelphia area?

Yes. Penn Medicine’s 1,400 residents and fellows became the largest new union in Philadelphia in 50 years when they voted to join CIR in 2023. Residents and fellows at the Rutgers University health system are also unionized.

Resident physicians are completing the final phase of their medical education. Fellows have already completed residency and are studying more specific medical specialities.

Unions among attending physicians, who have completed their medical training, are rarer, but attending doctors at ChristianaCare voted to unionize last year. They were the first group of attending doctors to unionize in the Philadelphia area.

What’s next for the new resident unions?

Now that they’ve voted to unionize, residents will negotiate contracts with their health systems.

Contracts can take time to negotiate. Penn residents unionized in 2023 and signed their first contract with the health system last fall. Rutgers residents signed their first contract in 2023 after negotiating for nearly a year.

Residents at CHOP could also vote again to unionize, and CIR officials said they would be “here for them when they’re ready to try again.” Residents who headed the union drive there said they plan to continue to organize and advocate for a union.