U.S. Main Residency Match Reveals New and Growing Specialty Interests
By Jessica Ridge

With a third consecutive year of record applications, this year’s main residency match revealed the culmination of hard work by medical students nationwide and a strong physician pipeline in growing specialties.  

When Match Week wrapped up on March 21 for the National Resident Matching Program (NRMP), there were new records for almost every category of the match, according to NRMP, with a 4.2% increase in offered positions and a 4.7% increase in filled positions. The number of unfilled positions declined 3.5% this year. 

Highlights from the Texas Medical Association’s analysis of state match data will be forthcoming, as well as the results from this year’s survey of Texas medical schools on the number of unmatched Texas medical school seniors. 

Of the 43,237 training positions offered, 94% (40,764) were filled:  

• Osteopathic seniors achieved a 92.6% match rate, the highest yet, an increase of 4.5% over 2024. 

• Allopathic seniors achieved a 93.5% match rate, comprising more than 20,000 students, 3.1% more than the previous year. 

A lot rides on the match, says Lisa Nash, DO, dean of the Texas College of Osteopathic Medicine.  

“For many [medical residents], it is a major factor in where they decide to practice, because so many of them will stay within 50 miles of where they complete their residency training. 

“One of the things we know is that the osteopathic profession has grown by leaps and bounds over the last decade,” Dr. Nash continued. “With one in four U.S. medical students now training in a college of osteopathic (DO) medicine, you see that reflected in the match – the numbers of our graduates in the match have grown considerably over the years.” 

Among the top specialties, dermatology, interventional radiology, orthopedic surgery, physical medicine and rehabilitation, plastic surgery, thoracic surgery, and vascular surgery filled every available position on Match Day.  Other strong specialties were anesthesiology, medicine-pediatrics, neurology, obstetrics-gynecology, otolaryngology, pathology, psychiatry, and surgery, which filled 99% of offered positions. 

Primary Care

• Internal medicine’s fill rate was 96.8%, an increase of 7.6 percentage points; 

• After an unexpected dip last year, the fill rate for pediatrics was 95.3%, an increase of 3.5 percentage points, even with 54 additional positions available; and 

• Family medicine’s fill rate was 85%, a decrease of 2.8 percentage points, which NRMP attributes to an increase of 144 available positions. 

Emergency Medicine

• Emergency medicine notched a 97.9% fill rate, an increase of 2.4 percentage points continuing the rebounding trend, largely attributable to increases in DO seniors and international medical graduates matching to the specialty, according to NRMP. This helps to restore the numbers closer to the pre-COVID-19 fill rate of 98 to 99 percent.   

Obstetrics-Gynecology

• Interest in the specialty remains strong, with only one OB residency position unfilled, for a fill rate of 99.9%. 

There was a small decrease in the number of U.S.-citizen international medical graduates participating in the match, down 3.5%. In contrast, the number of non-U.S. citizen international graduates increased by 14.4%.  

While this year’s 95.3% fill rate in pediatrics is a rebound from last year’s 91.8%, it still doesn’t match the 2023 rate of 97.1%. Dr. Nash sees room for particular improvement in Texas. 

“One of the challenges we’ve seen with graduate medical education growth over the recent past has been the way children’s health care is organized in Texas: predominantly around children’s hospitals with the loss of pediatric services in community hospitals. That’s really affected our ability to grow GME training in pediatrics in Texas. That is a huge opportunity for growth in the future if we can overcome some of those barriers.” 

Dr. Nash applauded NRMP’s first-time inclusion this year of two specialties, public health and preventive medicine and occupational and environmental medicine. While residency programs in preventive health are not new, she says, their absence from the match up until now made it difficult for medical school administrators to assess demand for implementing such a program at their institutions. 

“[The absence] really took away a set of tools that we use at least in part in assessing viability for new residency training programs,” Dr. Nash said.  

Learn more about Texas’ physician workforce on TMA’s dedicated webpage.