A union will not alter inter-departmental variation. Each department is unique in that has varied needs from other departments. You will continue to have your departmental benefits with a union. Program directors maintain flexibility to add benefits for their department in a unionized residency program. Additionally, what you currently have becomes the “floor”. It is unlawful – and considered retaliatory – if your department removes benefits after joining a union. That means if your program already pays for board exams, then your program has to continue paying for board exams in the future.