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

Reducing resident physicians’ brutally long work hours has been a CIR goal since its’ early years. In 1975, ground-breaking contract agreements eliminated the ubiquitous every other night call for 2,000 CIR members in New York City’s public and private hospitals. In 1989, CIR was at the forefront of the political push that created the first and only state work hour limits – the New York State Department of Health 405 Regulations. In 2001, CIR joined with the American Medical Student Association and Public Citizen to file a petition before the Occupational Safety and Health Administration, and helped introduce federal work hour legislation. The pressure from these actions was instrumental in convincing the Accreditation Council for Graduate Medical Education (ACGME) to establish its first ever across-specialty limit on hours in 2003. CIR continues to work to establish evidence-based work hour scheduling for resident physicians that optimizes the quality of patient care, resident education, and safety.

The American Medical Student Association (AMSA) is the oldest and largest independent association of physicians-in-training in the United States. AMSA is committed to improving health care and healthcare delivery to all people; promoting active improvement in medical education; involving its members in the social, moral and ethical obligations of the profession of medicine; assisting in the improvement and understanding of world health problems; contributing to the welfare of medical students, premedical students, interns, residents and post-MD/DO trainees; and advancing the profession of medicine.

AMSA continues to lead the campaign to reduce resident work hours through federal and state regulation. AMSA policy states that the Accreditation Council for Graduate Medical Education (ACGME) regulations are insufficient and do not ensure maximized patient and resident safety and health. AMSA, similar to CIR, believes residents maximum work per shift should not exceed 16 hours, including time for transfer of patient care and resident education. AMSA and CIR also advocate for a work week that does not exceed 80 hours and the removal of averaging hours worked over a period greater than one week.