Unifying allopathic (MD) and osteopathic (DO) applicants for the first time in a single matching program, 2020’s Match Day results underscored the continuing growth of DOs in the field, boosting numbers in primary care medicine and the Match as a whole.
The 2020 Main Residency Match bested 2019’s record as the largest in the history of the National Resident Matching Program (), with 40,084 applicants submitting program choices for 37,256 positions. This compares with 38,376 applicants vying for 35,185 positions last year.
It’s the seventh consecutive year in which overall match numbers are up, according to the NRMP. Although the number of applicants increased, so did the number of positions, resulting in a slight drop in the percent of positions filled during 2019-2020.
Available first-year (PGY-1) positions rose to 34,266, an increase of 2,072 (6.4%) over 2019. “This was, in part, due to the last migration of osteopathic program positions into the Main Residency Match,”, NRMP president and CEO, said in an interview. An agreement the Accreditation Council for Graduate Medical Education, American Osteopathic Association and American Association of Colleges of Osteopathic Medicine reached in 2014 recognized ACGME as the primary accrediting body for graduate medical education programs by 2020.
This led to the first single match for U.S. MD and DO senior students and graduates and the inclusion of DO senior students as sponsored applicants in 2020, Dr. Lamb noted.
Gains, trends in 2020 match
Growth in U.S. DO senior participation also pushed this year’s Match to record highs. There were 6,581 U.S. DO medical school seniors who submitted rank order lists, 1,103 more than in 2019. Among those seniors, 90.7% matched to PGY-1 positions, driving the match rate for U.S. DO seniors up 2.6 percentage points from 2019.
Since 2016, the number of U.S. DO seniors seeking positions has risen by 3,599 or 120%. “Of course, the number of U.S. MD seniors who submitted program choices was also record-high: 19,326, an increase of 401 over 2019. The 93.7% match rate to first-year positions for this group has remained very consistent for many years,” Dr. Lamb said.
Among individual specialties, the NRMP reported extremely high fill rates for dermatology, medicine-emergency medicine, neurological surgery, physical medicine and rehabilitation (categorical), integrated plastic surgery, and thoracic surgery. Other competitive specialties included medicine-pediatrics, orthopedic surgery, otolaryngology, and vascular surgery.
Participation of international medical school students and graduates (IMGs) went up in 2020, breaking a 3-year cycle of decline. More than 61% matched to first-year positions, 2.5 percentage points higher than 2019 – and the highest match rate since 1990. “IMGs generally are having the most success matching to primary care specialties, including internal medicine, family medicine, and pediatrics,” Dr. Lamb said.
Primary care benefits from DO growth
DO candidates also helped drive up the numbers in primary care.
Internal medicine offered 8,697 categorical positions, 581 more than in 2019, reflecting a fill rate of 95.7%. More than 40% of these slots were filled by U.S. MD seniors, a category that’s seen decreases over the last 5 years, due in part to administrative and financial burdens associated with primary care internal medicine.
“In addition, the steady growth of internal medicine has increased the overall number of training positions available, and with the growth of other specialties in parallel, it has also likely had some effect on decreasing the percentage of U.S. graduates entering the field,” Phil Masters, MD, vice president of membership and global engagement at the American College of Physicians, said in an interview.
However, fill rates for U.S. DO seniors reached 16% in 2020, a notable rise from 6.9% in 2016. “As the number of osteopathic trainees increases, we are happy that more are choosing internal medicine as a career path,” Dr. Masters said, adding that the slightly different training and practice orientation of osteopathic physicians “complements that of their allopathic colleagues, and add richness to the many different practice settings that internal medicine encompasses.”
A record number of DO seniors also matched in family medicine (1,392), accounting for nearly 30% of all applicants. The single match led to an important net increase in filled family medicine residency positions,, senior vice president for education at the American Academy of Family Physicians, said in an interview.
Overall, family medicine filled 92.5% of its 4,662 positions, 555 more than in 2019. The results show that family medicine and primary care are on solid footing, Dr. Knight said. “We are excited that the number of filled family medicine residency positions increased from last year. This is important as we work to meet the significant primary care workforce shortage,” he added.
In other specialties:
- Pediatrics filled more than 98% of its 2,864 categorical positions, 17 more than in 2019. U.S. MD seniors filled 1,731 (60.4%) of those slots. “We’re very excited about our newly matched pediatricians,” Sara “Sally” H. Goza, MD, president of the American Academy of Pediatrics, said in an interview. “The coronavirus outbreak has shown us how valuable the pediatric workforce is and how much we’re needed.’’
- Dermatology offered 478 positions, achieving a fill rate of 98.1%. “Looking at our own program’s Match results, I feel very satisfied that we are accomplishing our specific aim to serve rural populations and to create a diverse workforce in dermatology,” Erik Stratman, MD, an expert on dermatologic education in U.S. medical schools/residency programs, and a member of the American Academy of Dermatology, said in an interview. “It’s nice to see the fruits of the specialty’s expanding efforts to get the right people in the specialty who reflect those populations we serve.”
- Obstetrics-gynecology offered 1,433 first-year positions – 48 more than in 2019 – achieving a fill rate of 99.8%, with U.S. MD seniors filling more than 75% of those slots.
- Neurology filled more than 97.5% of 682 offered positions in 2020. However, U.S. MD seniors represented just under half of those filled positions (46.5%).
- Psychiatry offered 1,858 positions in 2020, achieving an overall fill rate of 98.9%, 61.2% for U.S. MD seniors.
- Emergency Medicine filled 99.5% of the 2,665 positions offered this year. In this profession, the U.S. MD fill rate was 64.3%. These new interns are sorely needed at a time when EM physicians are on the front lines of a pandemic, Hannah R. Hughes, MD, president of the Emergency Medicine Residents’ Association, said in an interview.