Amicus Brief Filed in Support of Collective Negotiations for Residents. JAMA. 1998;279(9):650M. doi:10.1001/jama.279.9.650
Prepared by Ashish Bajaj, Department of Resident Physician Services,
American Medical Association.
The February 18 Resident Forum reported on the issue of collective negotiations
between resident physicians and their institutions. As mentioned in that column,
the Committee of Interns and Residents (CIR), a labor union, has petitioned
the National Labor Relations Board to permit CIR to represent the residents
at Boston Medical Center. In late January the American Medical Association
(AMA) and the Massachusetts Medical Society (MMS) filed an amicus, or "friend
of the court," brief in the case.
The position of the AMA and MMS was based on their existing policies.
In the amicus brief, they stated that "residents have a unique status as participants
in graduate medical education programs and should have the right to negotiate
as a group about legitimate issues relating to patient care and resident well-being,
but they should not have the right to strike." However, both associations
agreed that the educational concerns of the training institution are paramount
and should not be subject to negotiation. Andrew Thomas, MD, the resident
member of the AMA Board of Trustees explained, "We are not asking that residents
have the right to negotiate the educational requirements of their residency
which are established by the ACGME [Accreditation Council for Graduate Medical
Education] and the Residency Review Committees. There may be, however, opportunities
for residents to negotiate how those requirements would be met. Other legitimate
issues for negotiation include adequacy of medical equipment, availability
of adequate laboratory and ancillary staff support, availability of adequate
call rooms, and security for physicians and patients."
The AMA and MMS amicus brief also stated that "the proper forum for
developing a model for residents seeking to negotiate with institutions is
the ACGME, which accredits and oversees virtually all graduate medical education
programs in the United States." Both medical associations believe that the
ACGME's current Institutional Requirements need to be amended to protect residents'
ability to negotiate without fear of retribution. Because of the AMA and MMS
position, the ACGME's Institutional Review Committee has already been reviewing
the Institutional Requirements and will be proposing several changes.
The AMA and ACGME are taking other steps on this issue. The AMA, through
its Division of Representation, is reviewing collective negotiation models
that already exist at some training institutions and will be developing ways
to help residents form negotiating groups. The ACGME is looking into ways
to implement stronger and quicker enforcement of its Institutional Requirements.
The AMA-Resident Physicians Section (AMA-RPS) is following this issue
closely and will continue to act on behalf of residents. To receive more timely
updates on collective negotiations and on other issues that effect resident
and fellow physicians, we encourage you to subscribe to the AMA-RPS blast
e-mail service. This service is only available to residents or fellows who
are members of the AMA. You can receive subscription instructions by sending
the message INFO AMA-RPS-L to the e-mail address: firstname.lastname@example.org. If you have any questions about collective negotiations or about
the AMA-RPS listserv, please contact Ashish Bajaj, AMA Department of Resident
Physician Services, at (312) 464-4743 or by e-mail: email@example.com.