Understanding Surgeon Unionization

The Board of Regents formed the Optimal Working Environment for Surgeons Task Force in early 2025 to develop objective, evidence-based resources to help ACS members understand the current landscape of physician unionization. The goal of these materials is to provide factual, balanced information about how unionization may affect surgeons and surgical trainees, including what can occur under union structures, and the legal and ethical considerations involved. This is an issue that touches the entire House of Surgery. 

The following FAQs, bibliographic references, and resource links are provided to help surgeons and residents make informed, independent decisions about unionization and their professional environment. Note: The ACS is not endorsing the union concept or creating a union; the resources are for information only. 

New Standards

The task force developed a structured framework of specialty-specific Workplace Standards for Surgeons—approved by the ACS Board of Regents and published in the Journal of the American College of Surgeons—to define sustainable clinical practice and align surgeon well-being with patient safety, system efficiency, and workforce stability.

Disclaimer

These materials are provided for informational purposes only and are not intended to provide professional, medical, or legal advice. Decisions regarding patient care must be made by the providing physician. Similarly, wage and compensation models are provided for informational and illustrative purposes only and are not intended to influence individual employment decisions, which must be made independently by the physician and their employer.