Monday, April 23, 2018

2018 Residency Match Update

The National Resident Matching Program Advance Data Tables for the 2018 Main Residency Match again show an increase in the number of first-year positions offered, going from 28,849 in 2017 to 30,232 this year.

Of the 18,818 seniors graduating from US allopathic medical schools, 17,740 (94.3%) matched, 1078 (5.7%) did not match, and 474 withdrew or did not submit a rank list. The 5.7% who went unmatched was identical to last year’s figure.

The 1511 graduates of US allopathic medical schools from previous years did not fare as well with 43.8% matching and 56.2% going unmatched—slightly worse than the 2017 percentages.

Osteopathic medical school applicants numbered 4617 with 81% matching. However 1227 withdrew from the match and 210 did not submit a match list. Note that there is also a separate osteopathic match.

The number of US citizen international medical graduates (IMGs) who matched improved by almost 2.3% with 57.1% of the 5075 applicants matching, 2175 (42.9%) did not match, and another 1911 either withdrew or did not submit rank lists.

The figures for non-US citizen international medical graduates were similar to those of US IMGs with 56.19% of the 7067 US IMG applicants matching.

There were 281 general surgery residency programs offering 1319 categorical (five-year) positions. Both numbers are increases from last year’s match which consisted of 267 programs offering 1281 positions. US seniors matched in 76.2% of the categorical positions, down by just over 2% from last year. As in 2017, five slots among three programs did not fill.

The total number of all PGY-1 positions filled through the match was 29,040 leaving 1192 unfilled slots, 475 of which were preliminary surgery PGY-1 positions. Compared to last year, the latter figure represents 33 fewer unfilled surgery prelim slots.

For the entire 2018 PGY-1 match, 8063 people went unmatched, 3121 withdrew, and 3685 did not submit a rank list. That means 14,869 graduates of US allopathic, US osteopathic, and international med schools failed to match. Assuming all of the 1192 unfilled slots were filled by some of those who did not match and some DO graduates secured positions in the osteopathic match, at least 13,500 people have no residency training positions and will not be able to obtain medical licenses.

This is a worrisome situation which I have blogged about several times in the past.

What does it all mean?

The squeeze continues to affect both US citizen and non-US citizen IMGs. New US medical schools and increased class sizes of established schools will make the situation for IMGs even worse. A post I wrote in October 2017 called “The lost sheep: They’re MDs but can’t find residency positions” highlighted the problem. It attracted many comments but no realistic solutions.


Purpleslog said...

Does the Military match fit into these numbers in some manner?

Skeptical Scalpel said...

The military match is separate and is held in December so those who do not match in a military program can go through the NRMP match. []

Purpleslog said...

Are they part of the withdrew and "did not submit" count then?

Skeptical Scalpel said...

Good question. I am not sure. They might be among the withdrew or did not submit groups. I tried to find some info on the numbers. After a quick search, I found the Army had 258 first year positions in 12 specialties as of 2015. [] I don't know about the other services but the Army is likely the biggest one.

I doubt there are more than a few hundred PGY-1 slots in the other services.

Purpleslog said... if that data were included the percentage outcomes would not change significantly.

Purpleslog said...

This link [ ] shows just under 1700 did the osteopathic match. Can MDs match to a DO program? I'm just trying to work out the numbers.

the Oracle said...

Are they going to other countries?

Skeptical Scalpel said...

If my assumptions are correct, the number of applicants who match to military programs is not large.

No, MDs cannot apply to the DO match. All DOs will be incorporated into the MD match in a year or two. I'm not sure what will happen to the DO match after that.

Debra Gottsleben said...

I really feel for those candidates who don't match. They have put in so much time and effort and money into becoming doctors that it just seems like there should be some way to get them some way to get licensed. But I'm wondering are some of these candidates just not up to grade? They didn't match because scores are low, not sure if recommendations are part of the process. If so did they get blackballed for some reason?

Skeptical Scalpel said...

Some didn’t match because scores and/or grades were low. Yes, letters of recommendation are part of it too. It’s also about numbers. There are far more applicants than positions. Lots of people aren’t going to match. It is sad but true.

Skeptical Scalpel said...

Oracle, sorry about the delay in posting your comment. It was a system error. If you are referring to the unmatched graduates, the answer is probably not. I would say few if any go elsewhere.

Anonymous said...

Somewhat related, but not entirely on topic... I watched a fine interview on TV tonight with former VA chief Shulkin who enumerated a list of services to veterans which the VA best provides. Along the way he stated that "the VA trains 70% of doctors in the country".
Are 70% of docs realistically completing a residency rotation through the VA? Just wondering if that's a reasonable number with your readers. Thanks for letting me ask.

Skeptical Scalpel said...

Good question. I cannot answer it. I will tweet it and see if anyone will respond.

Skeptical Scalpel said...

It didn't take long. See Table I of this document From @mksheikh

Anonymous said...

Thanks Skeptical for the VA info. While the 70% number is a bit exaggerated, a large percentage of docs do rotate through the VA. For 2016-2017:
Medical Students: 21%
Medical Residents: 35%
Fellows: 2%

SolitaryFlower said...

Thank you for linking to this!
It seems like there are so many unfilled positions. Can you talk about that, like, what leads to positions being unfilled- I mean I understand in broad strokes that the program couldn't find the right applicant. But I'm fascinated by how the number of unmatched graduates intersects, or ~doesn't~ intersect, with the thousands of unfilled slots.

Skeptical Scalpel said...

Solitary, the bulk of the unmatched positions are preliminary (1 year) surgery slots of which there are twice as many as are needed for applicants. Those going on to a specialty like ENT or ortho need a year of general surgery. If one doesn’t match in a specialty, one takes a preliminary spot in hopes a categorical (5 year) position become available in a year or two.

Post a Comment