1) In Canada, the working conditions of medical residents are negotiated on a province-by-province basis between provincial associations of residents and their respective employers. This paper focuses on the role of the Professional Association of Interns and Residents of Ontario (PAIRO).2) PAIRO negotiates working conditions with the Council of Academic Hospitals of Ontario and has obtained for its members a monthly salary of approximately 390,000 yen for first-year residents (the salary increases with each year of residency), a restriction of on-call duties to 7 of 28 days, and 4 weeks of paid vacation per year.3) In Japan, consideration should be given to the development of guidelines for the working conditions and salaries of residents based on the realities of each specialty and on local needs. To establish and enforce such guidelines, public funding and a third-party agency are necessary.