Resident Union Contract Benchmarks

What do resident physician unions actually win in their contracts? Explore provisions from landmark collective bargaining agreements at Stanford, Mass General Brigham, University of Michigan, and municipal health systems.

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Standard GME Contract vs. Union Collective Bargaining Agreement

The fundamental difference between an individual appointment agreement and a collective bargaining agreement (CBA) is enforceability and leverage. An individual agreement is written entirely by the hospital; a CBA is a binding bilateral contract.

Issue Area	Standard Non-Union GME Agreement	Union Collective Bargaining Agreement (CBA)
Salary & Raises	Set unilaterally by hospital GME committee each spring; no negotiation or guarantee against inflation.	Multi-year wage scale with contractually guaranteed annual raises (typically 3%–6%/yr) and COLA protections.
Housing Support	Discretionary; absent in most non-union programs despite high local rent and living costs.	Guaranteed annual housing or living allowance ranging from $4,500 to $12,000+ paid directly or as monthly stipends.
Meals & Food	Occasional cafeteria discounts or limited meal tickets during 24-hour in-house call.	Contractual annual food allowance ($1,200–$2,000/yr), 24/7 call room food access, and emergency shift meal money.
Licensing & Step 3	Residents frequently pay state training permits, renewals, and USMLE/COMLEX Step 3 registration out-of-pocket ($1,000–$2,000).	100% employer reimbursement for all mandatory training licenses, full medical licenses, DEA registrations, and Step 3 fees.
Fatigue Transportation	Residents responsible for commuting home safely regardless of sleep deprivation after 24-hour shifts.	Guaranteed employer-funded rideshare (Uber/Lyft) or taxi vouchers for fatigued residents leaving post-call shifts.
Disciplinary Due Process	ACGME requires an internal appeal, but final determination rests with the Program Director, GME committee, or Hospital CEO.	Strict 'just-cause' standard for all discipline, suspensions, and dismissals, with binding arbitration before an independent, neutral third party (AAA/FMCS).
Parental & Family Leave	Programs vary in how they implement the ACGME 6-week policy; taking leave frequently triggers extended training.	6 to 8 weeks of 100% paid parental and family medical leave with clear backup coverage mechanisms to minimize training extensions.

Landmark Resident Union Contracts Across the US

Verified provisions from ratified collective bargaining agreements across private non-profit, public university, and safety-net hospital systems.

Private non-profit academic~1,400 trainees

Stanford Health Care

Palo Alto, CA · Committee of Interns and Residents (CIR/SEIU Healthcare) · Term: 2023–2026

PGY-1 Base Stipend$83,500

Annual Housing Allowance+$10,000/yr

Orientation & Moving: $3,000 relocation stipend for incoming interns
Meal / Food Allowance: $1,800/year meal credit plus 24/7 nutrition lounge access
Licensing & Exam Reimbursement: 100% reimbursement for California training permit, full license, and USMLE/COMLEX Step 3
Fatigue Transportation: 100% employer-covered rideshare (Uber/Lyft/taxi) when fatigued post-call
Disciplinary Due Process: Just-cause requirement for all discipline, suspensions, and non-renewals; neutral, third-party binding arbitration through AAA
Parental & Family Leave: 6 weeks fully paid parental leave without extending training where specialty board rules allow
Patient Care / Work Environment Fund: $250,000 annual resident-administered fund for patient equipment, translation devices, and clinical supplies

Private non-profit safety-net~800 trainees

Boston Medical Center

Boston, MA · Committee of Interns and Residents (CIR/SEIU Healthcare) · Term: 2023–2026

PGY-1 Base Stipend$78,500

Annual Housing Allowance+$7,000/yr

Orientation & Moving: Paid orientation hours at full PGY-1 rate
Meal / Food Allowance: $150 per month cafeteria stipend
Licensing & Exam Reimbursement: Full coverage for Massachusetts limited licenses, full licenses, and exam registrations
Fatigue Transportation: Guaranteed taxi/rideshare vouchers after shifts exceeding 16 hours or overnight call
Disciplinary Due Process: Neutral third-party binding arbitration; union representation during any investigatory meeting
Parental & Family Leave: 8 weeks paid family/medical leave
Patient Care / Work Environment Fund: Joint quality improvement and patient care fund

Private non-profit academic~2,500 trainees

Mass General Brigham (MGB / Harvard Medical School)

Boston, MA · Committee of Interns and Residents (CIR/SEIU Healthcare) · Term: 2024–2027

PGY-1 Base Stipend$81,000

Annual Housing Allowance+$10,000/yr

Orientation & Moving: $2,500 onboarding stipend
Meal / Food Allowance: $2,000/year meal allowance across hospital cafeterias
Licensing & Exam Reimbursement: Full reimbursement of state training license, DEA, and Step 3 fees
Fatigue Transportation: Safe ride home program covering rideshares after 16+ hour shifts
Disciplinary Due Process: Just-cause discipline protection; independent grievance arbitration
Parental & Family Leave: 8 weeks paid parental leave
Patient Care / Work Environment Fund: Resident quality council fund for clinical improvements

Public municipal health system~3,000 trainees

NYC Health + Hospitals (11 Municipal Hospitals)

New York, NY · Committee of Interns and Residents (CIR/SEIU Healthcare) · Term: 2023–2026

PGY-1 Base Stipend$77,200

Annual Housing Allowance+$4,500/yr

Orientation & Moving: Chief resident differential ($4,500–$5,500/year)
Meal / Food Allowance: $1,500/year meal allowance
Licensing & Exam Reimbursement: Reimbursement for Step 3, NY state training permits, and ACLS/BLS/PALS certifications
Fatigue Transportation: Safe ride taxi vouchers
Disciplinary Due Process: Four-step grievance procedure culminating in binding arbitration via NYC Office of Collective Bargaining
Parental & Family Leave: Comprehensive city parental leave policy
Patient Care / Work Environment Fund: Over $3,000,000 in joint Patient Care Trust Funds for resident-purchased hospital equipment

Private non-profit academic~1,200 trainees

Montefiore Medical Center

Bronx, NY · Committee of Interns and Residents (CIR/SEIU Healthcare) · Term: 2023–2026

PGY-1 Base Stipend$78,000

Annual Housing Allowance+$8,500/yr

Orientation & Moving: Orientation stipend
Meal / Food Allowance: $1,800/year meal allowance
Licensing & Exam Reimbursement: 100% license and examination fee coverage
Fatigue Transportation: Reimbursed rideshare when leaving post-call
Disciplinary Due Process: Just-cause standard; expedited arbitration for suspension or dismissal
Parental & Family Leave: 6 weeks paid parental leave
Patient Care / Work Environment Fund: Resident quality improvement and wellness fund

Public university health system~1,300 trainees

University of Michigan Health (Michigan Medicine)

Ann Arbor, MI · House Officers Association (HOA - Independent) · Term: 2024–2027

PGY-1 Base Stipend$72,500

Annual Housing Allowance+$9,000/yr

Orientation & Moving: Paid orientation hours at full hourly rate
Meal / Food Allowance: $1,500/year dining card + meal money for emergency coverage
Licensing & Exam Reimbursement: 100% Michigan educational limited license and permanent license fees
Fatigue Transportation: Hospital-funded rideshare or taxi vouchers 24/7 post-call
Disciplinary Due Process: Progressive discipline, just-cause standard, and neutral binding arbitration
Parental & Family Leave: 6 weeks paid parental leave with backup call coverage system
Patient Care / Work Environment Fund: Contractually established work environment committee

Public university health system~1,400 trainees

University of Washington Medicine (UWMC / Harborview)

Seattle, WA · Resident & Fellow Physician Union - Northwest (RFPU-NW - Independent) · Term: 2022–2025

PGY-1 Base Stipend$75,000

Annual Housing Allowance+$8,400/yr

Orientation & Moving: $2,000 moving bonus
Meal / Food Allowance: $1,500/year meal cards + call-shift food credits
Licensing & Exam Reimbursement: 100% Washington training license and Step 3 fee coverage
Fatigue Transportation: Safe ride home program (reimburses rideshare up to $50/ride)
Disciplinary Due Process: Grievance procedure with external binding arbitration
Parental & Family Leave: Paid family leave supplemented by Washington state PFML
Patient Care / Work Environment Fund: Professional development fund ($1,500/resident/year)

Public university system~5,000 trainees

University of California System (UCSF, UCLA, UCSD, UC Davis, UCI)

California Statewide · Committee of Interns and Residents (CIR/SEIU Healthcare) · Term: 2023–2026

PGY-1 Base Stipend$82,000

Annual Housing Allowance+$12,000/yr

Orientation & Moving: Paid orientation and relocation support
Meal / Food Allowance: $1,200–$1,800/year meal allowances
Licensing & Exam Reimbursement: 100% license fee coverage
Fatigue Transportation: Campus-wide rideshare reimbursement program
Disciplinary Due Process: Just-cause discipline and external binding arbitration
Parental & Family Leave: 8 weeks fully paid family leave
Patient Care / Work Environment Fund: Joint labor-management patient care committees

About this data

Contract summaries are compiled from publicly available collective bargaining agreements, union announcements, and institutional labor disclosures. Terms such as annual stipends and housing supplements are subject to scheduled contract step adjustments over their active terms.