History of the UWHA

The University of Washington Housestaff Association (UWHA) has a long history of advocating for residents and fellows at the University of Washington (UW).  Originally formed in 1964, the UWHA provides for collective bargaining between University of Washington Residents and our employer. Since its founding, the UWHA has primarily focused on improving Residents' work environment. In 1964 residents nearly came to a strike from frustration with their low salaries, lack of fringe benefits, having to pay for call rooms, and no grievance procedures.  Through collective bargaining and with the support of Dean Aagard, the UWHA bargained for a raise and increased benefits avoiding a strike.

From 1974-75, the practice of summarily firing Residents without a grievance procedure or any due process came into question.  The UWHA pushed for a bonafide contract to address this and other issues.  A Memorandum of Understanding was created, but it did not become official policy. In 1975-76, Residents petitioned the UW for collective bargaining rights, but the Board of Regents demanded two things: (1) a study to be done by the Provost's office researching the Residents' complaints and (2) a policy statement be developed by the School of Medicine describing its policy towards housestaff. The study was done by an Mr. Olswang, an attorney backed by the Provost's office, who took call with Residents and did a survey. The results of his survey were treated as "confidential information" and were kept secret from the UWHA at that time. 

Six years later, the UWHA was given a copy of the study by individuals in the AMA Chicago office. Olswang notes in his report:

  • "I make no claim to be able to recommend that the hours worked by Residents are too many or too few to achieve the end result of preparing excellent doctors...I can only point out that the hours worked are long and often consist of numerable hours in succession without sleep. Combine this with the inability to secure meals, lower pay than their peers, seemingly inadequate communication mechanisms, and little self representation by Residents, and the outcome is some dissatisfaction by Residents....In conclusion, the allegations of severe work load by house officers resulting in improper patient care crystallize the overdue recognition that house officers are not being listened to collectively at this time. While there is no indication of improper patient care, it is clear that cooperation and mutual decision making between the house officers and the School of Medicine will produce greater satisfaction on the part of house officers so as to make patient care more reliable than it is presently."

In the mid-1970's, the result of Olswang's study led the dean's office to generate a policy statement alluding to the importance of housestaff needs and improving benefits. Throughout this time Residents pushed for an official contract.  During the course of many meetings between the UWHA, the medical school deans, AMA representatives, and large legal teams, a document called the "Blue-Book" was created. This became the first draft "contract" for Residents and provided for "mutual consent" (i.e., between residents and the UW School of Medicine). According to UWHA archives, the UW attorneys negated this document, eliminating the "mutual consent" and contractual language on the grounds that it represented acknowledgment of collective bargaining with Residents. In 1979 the "Blue Book" in its significantly revised form was adopted by the UWHA residents and UW representatives who formed the Housestaff Advisory Committee. In 1980, the advisory committee stopped meeting and the grievance procedures faded away. The School of Medicine never publicized the "Blue Book" and Residents again found themselves again demoralized without a contract and without any basis for negotiation.

In 1980, the UW administration did not recognize the UWHA as a representative of the Residents and refused to bargain.  Again Residents prepared to strike, and with the support of local medial outlets such as The Seattle Times and the Seattle Post-Intelligencer, the UWHA successfully negotiated a contract guaranteeing improvements in work conditions such as meals provided while on call, a grievance procedure, and better pay and fringe benefits. During the 1980-81 wave of Resident activism, there was much discussion on the legality of Residents negotiating as a collective bargaining unit. At that time Residents were clearly defined as students without the power or legal backing to collectively bargain. It was only by threatening a Resident strike, which would have effectively shut down the city's hospitals, that University officials were forced to recognize the Residents as a nonexclusive collective bargaining group. Following its success in 1981, the UWHA was in a a state of dormancy. Sometime in the early 1990's the UWHA ceased to exist with no regular meetings and no elected officers.

During that time, the Residency contract was revised to provide for an annual election of representative housestaff to serve on a Housestaff Advisory Committee. The Housestaff Advisory Committee was recently renamed the Institutional Resident and Fellow Advisory Committee (IR/FAC). In 1999-2000, the eight residents elected to the IR/FAC were eager to improve the dialogue and discussion about our work environment among the nearly 1,000 residents in the UW system. These eight IR/FAC residents drafted new bylaws, elected interim officers, and resumed control of the Housestaff Association dues accounts. Those funds allowed the development of this web-page, which was established to foster improved resident communication and a better work environment.  Since the time, the UWHA was active in improving the working condition for Residents.  Below is a brief summary of the advances in recent years: 

  • 2006 - Residents made eligible for paid civil leave.
  • 2007 - Housestaff not responsible for cost of parking at additional sites if required to travel to more than one training location on the same day. Compensation for attending program and UW Medicine orientation days.
  • 2008 - Residents not required to return compensation received for jury duty.
  • 2009 - Residents become eligible for UW retirement program.  Resident receive pay for extensions of training.
  • 2010 - A paid educational leave stipend is established. 
  • 2011 - The University agrees to not cease benefits for housestaff participating in overnight call on the last date of their appointment.  Residents convince the University to expand the hours for paid parking during home-call.
  • 2012 - Residents receive pay for time required to complete required online training modules if required prior to start date.  The Emergency Ride Home Program is established.
  • 2013 - The University commits to fulfilling terms of the current agreement and assisting placement into another program in the event that a training program is reduced or closed. The meal program is expanded to cover shifts that are 12 hours or longer. The UWHA Bylaws are ammended so that no more than two representatives from one speciality can be on the executive board.

In 2013, the UWHA became aware of increasing Resident frustrations and financial hardships.  A survey was conducted to better outline the pertinent issues.  The results of the study demonstrated that Residents were suffering from low wages relative to the cost of living in Seattle and high debt burdens. This issue was further compounded by the high cost of parking, where Residents were forced to pay thousands of dollars to care for their patients in contrast to the majority of residency programs that provide free or substantially subsidized parking. Finally, the UWHA found that Residents with children were particularly suffering due to the lack of daycare options and the high cost of childcare in Seattle.

The UWHA brought these issues to the University's attention, but we were unfortunately met with heavy resistance.  The UWHA leadership recognized that the only way to move forward without the continued trials and tribulations encountered over the past 60 years, the UWHA proposed to restructure into a state-recognized collective bargaining unit.  The University filed a petition to the State Supreme Court attempting to block this movement by arguing that Resident's were "students" who were paid a "stipend" and not employees receiving a salary.  The University also hired outside consultants and lawyers to block this advance. However, the State Supreme Court recognized the value of services provided by Residents to the region's patients and determined that they were in fact employees with the right to unionize.  Thus, despite an extensive propaganda campaign and legal challenges by the University, in the Fall of 2014 UW Residents overwhelmingly voted (>75%) in favor of forming a union.

Negotiations between the UWHA and UW began in January of 2015 and continued for almost two years. After 20 months of negotiations, the UWHA and UW reached a new contract. This contract included:

  • significant salary increases,
  • new housing and parking stipends 
  • reimbursment for medical licenses and other required expenses
  • an annual education fund for all residents
  • an experimental childcare and transportation fund
  • extended paid leave for residents with serious medical issues
  • increased bereavement leave
  • legal protections to prevent residents from unfairly being disciplined or terminated
  • a fair process that guarantees the right to moonlight for all residents

The new was brought to the housestaff, who voted overwhelmingly (>99%) to ratify it. The new contract went into effect on November 1, 2016. Since ratification, implementation has proceeded generally smoothly. There have been some issues such as when UW attempted to reneg on medical license reimbursements, but fortunately these issues have been resolved.

The mission of the UWHA is to advocate for housestaff rights and ensure that all residents and fellows have a safe work environment and are fairly compensated for their labor.