Residency Match Day Is Largest in History

Megan Brooks

Disclosures

March 15, 2019

The 2019 Main Residency Match celebrated its largest in history, with a record 38,376 US and international applicants listing program choices for 35,185 positions, the National Resident Matching Program (NRMP) announced today.

The number of available first-year (PGY-1) positions rose to 32,194, an increase of 1962 (6.5%) over 2018. The influx of positions is due, in part, to the increased numbers of osteopathic programs that joined the Main Residency Match as a result of the ongoing transition to a single accreditation system for graduate medical education programs, the NRMP noted.

In a statement, Association of American Medical Colleges (AAMC) President and CEO Darrell G. Kirch, MD, congratulated the "more than 30,000 future doctors" who matched to PGY-1 residency training positions at the nation's teaching hospitals.

"More applicants are expected to match with the completion of the Match Week Supplemental Offer and Acceptance Program," he said.

Overall, 79.6% of applicants matched to PGY-1 positions, and 94.9% of PGY-1 positions were filled, according to the NRMP.

 

Primary Care Highlights

Of the 32,194 first-year positions offered this year, 15,946 were in the primary care specialties, a 7.8% increase over the number offered in 2018. Within the primary care slots, 15,355 (96.3%) were filled, and 7272 (45.6%) were filled by US allopathic seniors. Other highlights in primary care:

  • Internal medicine programs offered 8116 categorical positions (574 more than in 2018); 7892 (97.2%) positions were filled, with 3366 (41.5%) filled with US allopathic seniors. The percentage of internal medicine categorical positions filled by US allopathic seniors has declined every year since 2015, according to the NRMP.

  • Family medicine programs offered 4107 positions (478 more than in 2018); 3827 (93.2%) positions were filled, 1601 (39.0%) by US allopathic seniors. This year was the first since 2009 that the number of US allopathic seniors matching to family medicine decreased; however, a record number 986 osteopathic students and graduates matched in family medicine, accounting for 25.8% of all applicants who matched to the specialty.

  • Pediatrics programs offered 2847 categorical positions (79 more than in 2018); 2778 (97.6%) were filled, and 1715 (60.2%) were filled by US allopathic seniors. The percentage of US allopathic seniors matching to pediatrics has declined every year since 2015.

What Specialties Are Hot?

The results of the Match provide insight into the competitiveness of specialties, as measured by the percentage of positions filled overall and the percentage filled by senior students in US allopathic medical schools. Among the highlights this year:

  • The specialties with more than 30 positions in which all available positions were filled were integrated interventional radiology (categorical and advanced), otolaryngology, physical medicine and rehabilitation (categorical), integrated plastic surgery, surgery (categorical), and thoracic surgery.

  • The specialties with more than 30 positions in which more than 90% were filled with US allopathic seniors were integrated plastic surgery, neurologic surgery, orthopedic surgery, otolaryngology, and thoracic surgery.

  • The specialties with more than 30 positions in which fewer than 45% were filled with US allopathic seniors were family medicine, internal medicine (categorical), pathology, pediatrics (primary), and surgery (preliminary).

Trends in Other Specialties

  • Emergency medicine programs offered 2488 first-year positions (210 more than in 2018) and filled all but 30. Since 2015, the number of emergency medicine positions has increased by 36.6%.

  • Psychiatry programs offered 1740 positions (184 more than in 2018) and filled all but 20. The number of psychiatry positions has increased by 28.6% since 2015.

  • Radiation-oncology advanced programs offered 192 positions (15 more than in 2018) but filled only 163 (84.9%), a sharp drop from prior years, in which only a handful of positions were unfilled.

  • Other specialties with at least 30 PGY-1 positions that increased by more than 50 first-year positions over 2018 were anesthesiology (84 more positions, 6.7% increase), obstetrics-gynecology (59 more positions, 4.4% increase), and neurology (65 more positions, 11.8% increase).

  • The number of general surgery (categorical) positions has increased by 208 since 2015 (17.0%); 113 of those were added this year.

Record Number of Applicants

The number of Match registrants in 2019 set a record at 44,603. The increase was due largely to students/graduates of US osteopathic medical schools, whose numbers grew by 1036 (17.1%) over 2018 to 7090 this year. Other applicant highlights:

  • The number of US allopathic medical school seniors who submitted program choices was a record high 18,925, an increase of 107 over 2018; 17,763 (93.9%) matched to first-year positions, the highest number ever. The 94% PGY-1 match rate for US allopathic seniors has remained consistent for years.

  • The number of US osteopathic medical school students and graduates who submitted program choices also was a record high at 6001, an increase of 1384 over 2018. Of those 6001, 5076 (84.6%) matched to PGY-1 positions, also a record. Since 2015, the number of US osteopathic medical school students and graduates seeking positions has risen by 3052, a 103% increase. That growth has been driven in part by the transition to a single accreditation system. As part of that transition, the American Osteopathic Association Match has ended, the NRMP says.

  • There were 5080 US citizen international medical school students and graduates (IMGs) who submitted program choices, an increase of five over 2018; 59% (2997) matched to PGY-1 positions, the highest rate since 1991.

  • The number of non-US citizen IMGs who participated in the Match fell for the third straight year. In 2019, 6869 IMGs submitted program choices, down 198 from 2018, 415 from 2017, and 501 from 2016. However, 4028 IMGs (58.6%) matched to first-year positions, which is 2.5 percentage points higher than 2018 and the highest rate since 1990.

Challenges Ahead

Many challenges lie ahead, according to the AAMC. In his statement, Kirch noted that "new doctors will enter a health care system facing challenges, including a projected physician shortage of more than 121,000 physicians by 2030.

"Over the years," he added, "medical schools have done their part to address the coming shortage by gradually increasing enrollment. Despite these efforts, a more than 20-year-old cap imposed by Congress on the number of federally supported residency positions stymies growth in the number of available training positions.

"As part of a multipronged strategy to meet the physician workforce needs of the nation, the AAMC has consistently endorsed legislation to expand the number of federally supported residency positions and allow the nation's teaching hospitals to train more physicians," said Kirch.

"In addition to preparing more doctors to address the shortage, US medical schools and teaching hospitals are innovating with new and more efficient care delivery models, training physicians on interprofessional health care teams, and developing and using technologies, like telehealth, to improve the quality of and access to care patients need when they need it," Kirch noted.

Details of the 2019 Main Residency Match are available online.

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