After years of advocacy and negotiation, HSA secured a memorandum of understanding (MOU) with GME leadership in 2026 — formalizing our role as the voice of residents and fellows at the University of Colorado. The MOU guarantees regular meetings with GME and School of Medicine leadership, a structured process for annual stipend and benefits negotiations, a dispute resolution process, and HSA representation on key institutional committees. HSA's seat at the table is no longer informal — it's official.

This is a major milestone, but an MOU is not a collective bargaining agreement. While it establishes a strong working relationship and concrete commitments, it does not carry the full legal protections of a union contract.

Unlike our unionized peers in other states, HSA does not have full collective bargaining rights. This means hospital leadership does not have to honor the promises it makes at the table; they are not legally obligated to uphold any agreement they make with us through the HSA. HSA cannot force leadership to come to the table or to grant a legally binding contract.

HSA was always intended to be a union for residents and fellows. Unfortunately, Colorado state law has yet to grant public workers collective bargaining rights.

We have asked hospital and GME/SOM leadership to permit a guaranteed seat at the table for contract negotiations, thereby instituting formal collective bargaining to work toward a collective bargaining agreement (CBA), a union contract that is legally binding. There is no law that forbids CU GME/SOM or hospital leadership from permitting this request, but HSA recognizes this demand may not be granted without some convincing.

Collective bargaining won’t look much different from the advocacy HSA has already been doing for more than 50 years on behalf of housestaff. Each program would still have representation on the HSA Executive Committee, dues will still be collected, and contract negotiations will move forward with hospital leadership.

The main difference is all about accountability: Full collective bargaining means protections and a legally binding contract. What is promised will be given.

Colorado is a modified right-to-work state, meaning employees can vote to form a union, but it’s not a condition of employment. Federal law gives most private sector workers in Colorado the right to unionize, but Colorado public sector workers (like HSA members) must gain unionization through voluntary recognition from an employer. HSA has been recognized for decades as the sole representative to advocate on behalf of housestaff and is now codified as such through the MOU, but we do not have collective bargaining.

Due to increased requests to explore this option, we sent a survey to HSA membership to gauge interest and saw 75% of respondents are in favor. We also collected more than 900 signatures of current HSA members saying yes, they want to full unionization with collective bargaining.

Opt in now to become a dues-paying member and learn more about how to join the Organizing Committee and/or Executive Committee. You can also follow and message us @cuhousestaff on Instagram or reach out to our organizer, Liza (720-744-2509, liza@cuhousestaff.org).