What’s the news: Following a trend seen for half a decade, the 2023 Main Residency Match once again broke the record for offering the highest number of total positions in the program’s 70-year history: 40,375 certified positions.
This is an increase of 1,170 positions from 2022, adding to growth of 14.8% over the past five years. Almost half of these positions were in primary care. This year, another 183 programs participated in the match.
The data shows that 81.1% of all active applicants are matched to graduate level 1 (PGY-1) positions and 93% of those positions are filled.
There were 42,952 applicants who certified a rank list, the highest number on record and an increase of 403 applicants compared to 2022. Among this group, 34,822 matched the PGY-1 position, an increase of 1 percentage point over last year year.
A total of 48,156 applicants registered for the 2023 Main Residency Match, marking 481 more registrants than the previous year. Non-US international medical graduates (IMGs) primarily drove the increase, with 707 more non-US IMG applicants and 153 more US DO retirees this year compared to 2022.
Surprisingly, Match officials said there were 246 fewer U.S. retirees who signed up for Match this year compared to last year. There were 19,748 retirees in the U.S. this year, compared to 19,902 last year.
Why it’s important: Given the concern about physician shortages, offering more positions will help begin to fill this anticipated gap. Match rates increased among almost all applicant types. Compared to the 2022 primary residence match numbers, this year MD retirees in the US had a match rate of 93.7%, an increase of 0.8 percentage points. This group has held steady with a 92–95% match rate since 1982. US DO retirees saw a 91.6% match rate, an all-time high and a 0.3 percentage point increase over last year.
“We are extremely proud of the Class of 2023 graduating DOs and the dedication, flexibility and determination they have shown as they navigated the ever-changing landscape and challenges they faced during their four years of medical school,” said Robert A. Kane, DO, president and CEO of the American Association of Osteopathic Colleges.
“I am particularly pleased that as we see the number of senior DOs increasing, we are also seeing an increase in the number of matches,” Dr Kane added. “It is a testament to the talent and ability of our seniors and the teaching and training they receive at our Colleges of Osteopathic Medicine. The entire osteopathic community can be proud of this continued growth and success.”
Meanwhile, US citizen IMGs had a 67.6% match rate, also an all-time high and up 6.2 percentage points from last year. Non-US citizen IMGs had a 59.4% match rate, up 1.3 percentage points from last year. The fill rate also remained high this year. Among all positions offered, 37,690 were filled during the 2023 Main Residency Match, with a fill rate of 93.3%. This represents a decrease of less than 1 percentage point from 2022.
Among the 37,425 PGY-1 positions, which include advance and transition year positions, there was a 93% fill rate. The fill rate for categorical positions — positions that provide the full training required for specialty certification — was 97.5 percent this year.
Of the total 6,270 certified programs, 5,431 were filled during the match for a rate of 86.6%. This is a decrease of 1.6 percentage points compared to last year.
Notably, there were an additional 571 positions in primary care, allowing for the highest number of positions to be offered at a time when the nation is facing a severe and growing shortage of primary care physicians. The figure marks a 3.2 per cent increase on last year and a 17 per cent increase over the past five years, with numbers rising in each of those years.
Primary care positions were filled at a rate of 94.2%, which remained steady from last year.
“The 2023 Main Residence Match has once again proven to be a hugely successful match with outstanding results for the participants. We were thrilled to see the record number of primary care positions offered at this year’s match and how the number of positions has steadily increased over the past five years, and most importantly, the primary care fill rate has remained stable,” said Donna L. Lamb, president and CEO of the National Resident Matching Program, which administers the match and provides advanced data for it.
Orthopedic Surgery, Plastic Surgery (Integrated), Diagnostic Radiology, and Thoracic Surgery were the specialty programs with 30 positions or more that filled all available positions.
Emergency medicine has offered 3,010 of its positions – 89 more than last year – but 554 positions remain unfilled after the match. This is 335 more unfilled positions than last year. Match officials believe this is “due in part to the reduced number of US MD and US DO adults who submitted specialty ranks” and that it “may reflect changing applicant interest or projections about post-residency workforce opportunities.”
In a joint statement, emergency medicine organizations said that with the recent pandemic and the results of the last two games, times are challenging for the specialty. Organizations work to ensure medical students fully understand the specialty by proactively demonstrating the benefits of emergency medicine careers and addressing negative perceptions.
“We reaffirm our responsibility and commitment to actively engage,” the American College of Emergency Physicians and 10 other organizations said in the statement. The major “continues to attract talented and dedicated students and remains one of the most popular majors for students,” and they expressed confidence that vacancies will be filled “with great new residents” through the Supplemental Offer and Acceptance Program (SOAP).
Match officials said the data can show the competitiveness of specialties when measured by the percentage of positions filled overall and the percentage of positions held by U.S. MD and DO retirees. The specialties with 30 positions or more that are filled with the highest percentage of US MD and DO retirees in the 2023 match are:
- Plastic surgery (integrated): 92.3%.
- Internal Medicine – Pediatrics: 90.5%.
- Obstetrics and gynecology: 90.1%.
- Orthopedic surgery: 90%.
Applicants not matched to a residency position through the Basic Residency Match had the opportunity to participate in SOAP. This year, 2,685 positions were unfilled after processing the matching algorithm — 423 more positions and an 18.7% increase over last year. SOAP results will be available in the full match report scheduled to be published in the spring.
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