Committee of Interns & Residents

History

The Committee of Interns and Residents (CIR) is the largest housestaff union in the United States, representing more than 13,000 residents in California, Florida, Massachusetts, New Jersey, New York, New Mexico, and Washington, D.C. CIR contracts seek to improve housestaff salaries and working conditions as well as enhance the quality of patient care. CIR was founded in 1957.

In May 1997, CIR affiliated with the 1.6 million-member Service Employees International Union (SEIU), which represents over 1 million healthcare workers nationwide. Its affiliation with SEIU has increased its strength wherever CIR represents housestaff.

CIR was originally founded by interns and residents in New York City’s public hospitals. In 1958, CIR achieved the first collective bargaining agreement for housestaff anywhere in the U.S. By the mid-1960s, CIR had established the only housestaff-administered benefit plan. By 1969-70, members in the private, or voluntary, sector started organizing and joining CIR. The CIR leadership is composed largely of primary care and medical subspecialists and its positions are controversial among surgical trainees. Additionally, the organization is heavily supportive of a progressive political agenda.

In a landmark achievement in 1975, CIR won contractual limits for on-call schedules of one night in three. In the late 1980s and early 1990s, CIR successfully negotiated innovative maternity leave clauses, won provisions for pay for housestaff covering for absent colleagues, and in 1989 helped shape New York State’s regulations that set maximum work hour limits for housestaff.^[1] Since then, CIR members have negotiated hours limitations and program security clauses in Miami, Los Angeles and Boston.^[2]

Mission

According to its website CIR's mission is to: "bring together interns, residents, and fellows in a democratically-run, chapter-based organization whose purpose is to represent the interests of its doctor-members and the patients and communities they serve through the use of collective bargaining and resident advocacy."^[3]

The Three Pillars

CIR articulates its mission in relation to three "pillars" of action. These are: "Collective Bargaining," "New Organizing," and "Patient Advocacy through Policy and Political Action."

Core Values

CIR refers to these core values as underlying its mission: 1) Better working and training conditions for residents. 2) A more humane, effective, accessible, and quality healthcare system for all.

Means

To advance common goals, CIR engages in organizing, negotiates and enforces contracts, advocates for patients, and engages in political action. CIR builds cooperation among housestaff from all specialties and also works in coalitions with other healthcare employees, other unions, community and patient groups, medical students, and professional organizations.

Elected officers at the chapter, regional, and national levels represent the diversity of CIR’s members and the range of institutions and regions in which they work. CIR pools resident resources nationally to provide staff, technical support, and organizational continuity to enable housestaff to have an effective voice on the issues they and their patients face.

References

Further reading

Ludmerer, Kenneth M. Time to heal: American medical education from the turn of the century to the era of managed care. Oxford University Press, 1999.

Mullan, Fitzhugh. White Coat, Clenched Fist: The Political Education of an American Physician. University of Michigan Press, 2006.

Peterkin, Allen. Staying human during residency training: how to survive and thrive after medical school. University of Toronto Press, 2008.

Institute of Medicine (U.S.). Committee on Optimizing Graduate Medical Trainee (Resident) Hours and Work Schedules to Improve Patient Safety. Resident duty hours: enhancing sleep, supervision, and safety (Google eBook).