5-Minute Summary: Voices in Orthopaedics™…The Unionized Orthopod: Apprenticeship, Labor, and the Changing Identity of Orthopedic Residency at Jefferson

Resident physician unionization has accelerated across the United States in recent years, reflecting broader changes in healthcare systems, physician expectations, and the economics of medical training. At Thomas Jefferson University Hospitals, residents recently voted to unionize and are currently in the midst of contract negotiations, placing these national conversations directly into the daily lives of trainees across all specialties here. Within orthopedic surgery, these issues carry unique complexity. Orthopedic residency has historically embraced an apprenticeship model deeply rooted in long hours, graduated autonomy, mentorship, and personal sacrifice. Residents are not merely employees performing labor, but trainees undergoing professional and personal development. The emergence of organized labor within residency programs therefore raises challenging questions. Are orthopedic residents primarily learners or workers? Can surgical training maintain its apprenticeship ethos within increasingly contractual labor structures? Which aspects of residency hardship are educationally meaningful versus unnecessarily burdensome? This editorial explores the evolving intersection of unionization and orthopedic residency culture through the lens of modern orthopedic resident trainees at Rothman Orthopedics at Thomas Jefferson University Hospital.