Who Matched and Who Didn’t? | Nutrition Fit

The National Resident Matching Program (NMRP) announced this afternoon that this year’s Main Residency Match was the largest in its history.

A total of 38,106 positions were offered, up 850 spots (2.3%) from 2020. Of those, 35,194 were first-year (PGY-1) positions, which was 928 more than the previous year (2.7%). A record 5915 programs were part of the Match, 88 more than 2020.

“The application and recruitment cycle was upended as a result of the pandemic, yet the results of the Match continue to demonstrate strong and consistent outcomes for participants,” Donna L. Lamb, DHSc, MBA, BSN, NRMP president and CEO, said in a news release.

The report comes amid a year of Zoom interview fatigue, canceled testing, and virus fears and work-arounds, which the NMRP has never had to wrestle with since it was established in 1952.

Despite challenges, fill rates increased across the board. Of the 38,106 total positions offered, 36,179 were filled, representing a 2.6% increase over 2020. Of the 35,194 first-year positions available, 33,535 were filled, representing a 2.9% increase.

Those rates drove the percentage of all positions filled to 94.9% (up from 94.6%) and the percentage of PGY-1 positions filled to 94.8% (also up from 94.6%). There were 1927 unfilled positions, a decline of 71 (3.6%) from 2020.

Primary Care Results Strong

Of the first-year positions offered, 17,649 (49.6%) were in family medicine, internal medicine, and pediatrics. That’s an increase of 514 positions (3%) over 2020.

Of first-year positions offered in 2021, 16,860 (95.5%) were filled. US seniors took 11,013 (65.3%) of those slots; that represents a slight decline (0.3%) from 2020. Family medicine saw a gain of 63 US MD seniors who matched, and internal medicine saw a gain of 93 US DO seniors who matched.

Some Specialties Filled All Positions

PGY-1 specialties with 30 positions or more that filled all available positions include dermatology, emergency medicine, pediatrics, neurologic surgery, otolaryngology, integrated plastic surgery, and vascular surgery.

PGY-1 specialties with 30 positions or more that filled more than 90% with US seniors include dermatology (100%), emergency medicine (93.6%), pediatrics (93.5%), otolaryngology (93.2%), orthopedic surgery (92.8%), and integrated plastic surgery (90.4%).

PGY-1 specialties with at least 30 positions that filled less than 50% with US seniors include pathology (41.4 %) and surgery–preliminary (28%).

The number of US citizen international medical graduates (IMGs)who submitted rank-ordered lists was 5295, an increase of 128 (2.5%) over 2020 and the highest in 6 years; 3152 of them matched to first-year positions, down two PGY-1 matched applicants over last year.

The number of non-US citizen IMGs who submitted ranked lists grew by 1036, to 7943, a 15% increase over 2020; 4356 of them matched to first-year positions, an increase of 134 (3.2%) and the highest number ever.

Educational Commission for Foreign Medical Graduates (ECFMG) President and CEO William W. Pinsky, MD, said in a press release that he was pleased with the results. “IMGs play an important role in providing supervised patient care, contribute much needed diversity to our nation’s health care system, and help to address the nation’s growing physician shortage that is being exacerbated by the pandemic,” he said.

The higher numbers among non-US citizen IMGs was one of the biggest surprises in the report, Bryan Carmody, MD, MPH, told Medscape Medical News. Carmody is a pediatrician with the Children’s Hospital of the King’s Daughters, in Norfolk, Virginia, and is a frequent critic regarding medical education issues.

“I expected that the disruption to the USMLE [United States Medical Licensing Examination], the ECFMG’s new ‘pathways’ to replace Step 2 CS, the challenges with travel and completing US electives, etc, would have decreased the number of IMG applicants,” he said.

Less Celebrations, More Emails

Troy Amen, MD, MBA, co-president of his class at Harvard Medical School, was thrilled to find that he had matched into orthopedic surgery at the Hospital for Special Surgery in New York City. His fiancé, a Harvard Business School student, landed a job at a consulting group in downtown New York.

“We’re thrilled we’re going to be in the same city,” Amen said. “We’re getting married this summer, and everything has just fallen into place.”

As is the case across the country, because of COVID-10, Harvard medical school students opened up emails at the same time and celebrated with the deans in a series of Zoom calls.

On the opposite end of the spectrum, the worst form of match news came early for Kolin Meehan, MD, who graduated in December from West Virginia University School of Medicine, in Morgantown. He got news on Monday that he had not matched through the main route. On Thursday morning, he found that he had matched through the Supplemental Offer and Acceptance Program.

“This week was the worst roller-coaster of emotions in my life,” Meehan told Medscape Medical News. He quickly scrambled to get more letters of recommendation after seeking last-minute interviews and advice from deans and attendings. Still, he says, the process works. He will start an internal medicine residency in July at Regional Medical Center Bayonet Point in Hudson, Florida.

Carmody said the biggest lesson from today’s numbers “is that the Match is not fragile.

“Applicants have a strong incentive to match, and programs have a strong incentive to fill, and those incentives were enough to largely overcome the real challenges that this year’s application cycle presented,” he said. “You could look at the relatively stable Match rate and conclude that everything’s hunky-dory and nothing needs to be improved about the residency application process. But instead, I think the better lesson is that there is room to innovate and improve. The Match isn’t going to break if we make changes.”

Full data are available on the NRMP’s website.

Marcia Frellick is a freelance journalist based in Chicago. She has previously written for the Chicago Tribune and Nurse.com and was an editor at the Chicago Sun-Times, the Cincinnati Enquirer, and the St. Cloud (Minnesota) Times. Follow her on Twitter at @mfrellick.

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