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Residency Matching Rates Down This Year

— Surge in registrants driven by pandemic; numbers of matches set records

MedpageToday
MATCH DAY 2021 over a series of charts and graphs

The percentage of total registrants matched to first-year residency positions declined this year from the 2020 figure, as the number of registrants surged and issues caused by the pandemic emerged, released by the National Resident Matching Program (NRMP).

Meanwhile, the total number of positions filled and number of first-year positions filled both set records, as new programs welcomed residents via Match Day.

The NRMP data found that the percentage of registrants matched to first-year positions declined from 80.8% to 78.5%, with a record number of 48,700 registering -- 8.3% higher than last year. The percentage of 4th-year U.S. allopathic medical school students matching to first-year positions declined from 93.7% to 92.8%; the percentage for U.S. osteopathic medicine degree earners declined from 90.7% to 89.1%.

International medical school graduates (IMGs) who are not U.S. citizens were especially affected -- their matching rate dropped from 61.1% to 54.8%.

"The unavailability of medical licensure examinations in the early stages of the pandemic coupled with permanent changes to the scoring and administration of those examinations by the end of 2020 created significant challenges for IMGs this year and likely contributed to the decline," noted . "Additionally, changes in clinical rotations may have affected match rates."

This year's residency cycle was more competitive, said Clarence Braddock III, MD, vice dean of education at the David Geffen School of Medicine at University of California Los Angeles. He cited an increasing number of graduating students and the relatively static number of available residency spots. "The prospect of not matching is a lot more foregrounded in people's minds than it has been in the past," he told 51˶. "That's not a new phenomenon, but each year it gets a little bit more pronounced."

Those submitting program preferences numbered 42,508, up 6% over last year.

Raw numbers regarding matching were also up, with some setting records. Of the 38,106 total positions available, 36,179 were filled -- a 2.6% increase over last year. Of the 35,194 first-year positions available, 33,535 were filled -- a 2.9% increase.

The percentage of all positions filled increased by 0.3%, to 94.9%, and the percentage of first-year positions filled increased by 0.2%, to 94.8%.

The rate of U.S. MD graduates matched to first-year positions increased from 45.6% to 48.2%, while U.S. DO graduates matching to first-year positions increased from 43.1% to 44.3%.

51˶ that filled all available positions (with at least 30 positions) included dermatology, emergency medicine, pediatrics, neurological surgery, otolaryngology, integrated plastic surgery, and vascular surgery.

51˶ that filled less than 50% of available positions with U.S. seniors included pathology (41.4%) and surgery (28%).

A record 5,915 programs participated, 88 more than last year, with the number of such programs increasing by 16.7% over the last 5 years. That surge has been "spurred in part by the completion of the transition to the single accreditation system," with DO and MD programs merging into a single matching system, according to the NRMP.

The number of U.S. citizen international medical school graduates who submitted program lists increased 2.5%, to 5,295 -- the most in 6 years -- and 3,152 of them matched to first-year positions, down two spots over last year.

The number of non-U.S. citizen international medical school graduates who submitted lists increased by 15%, to 7,943; a record 4,356 of them matched to first-year positions -- up 3.2%.

NRMP reported 1,927 spots unfilled this year, down 3.6% from last year; some unmatched residents will be placed in those spots via the NRMP Match Week Supplemental Offer and Acceptance Program (SOAP), with final figures to be shared publicly in May.

These data follow recent reports that applications to medical schools soared this cycle. Medical schools cannot accommodate the surging demand, sources told 51˶, in part because residency program spots have not been increasing at the same rate as their applications. While the rate of residency positions per active applicant has increased slightly since 2010, that figure is still down over 2003, and well below the rates of the late 1980s and early 1990s.

"The AAMC [Association of American Medical Colleges] supports bipartisan legislation that would gradually add 15,000 Medicare-supported residency positions over 5 years," the organization said in December.

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    Ryan Basen reports for MedPage’s enterprise & investigative team. He often writes about issues concerning the practice and business of medicine, nurses, cannabis and psychedelic medicine, and sports medicine. Send story tips to r.basen@medpagetoday.com.