Impact of the ACGME Merger on Ophthalmology Match Success: A Pre- and Post-Merger Comparative Analysis

Background In 2020, the ACGME merger unified the residency match process for MD and DO applicants into a single, standardized system. The merger aimed to promote equity in graduate medical education by streamlining training pathways and matching processes across applicant backgrounds. Hypothesis Despite the merger’s goal of standardization and equity, disparities in ophthalmology match outcomes between MD and DO applicants may persist. Methods Data from the SF Match and AUPO were collected for ophthalmology applicants from 2016 to 2024. Applicants were divided into pre-merger (2016–2019) and post-merger (2020–2024) cohorts. Match rates for MD and DO applicants were calculated and compared between these periods using chi-square analysis. Results Results showed a statistically significant decline in match rates for MD applicants, from 85.32% pre-merger to 78.26% post-merger (p < 0.05). DO match rates also declined, from 45.07% to 38.62%, but this change was not statistically significant (p ≥ 0.05). In both time periods, MD applicants had significantly higher match rates than DO applicants (p < 0.05). Conclusion Although the ACGME merger was intended to promote equity, disparities in ophthalmology match outcomes between MD and DO applicants remain. The non-significant downward trend in DO match rates may reflect persistent challenges such as fewer rotation opportunities, limited advising, and reduced program familiarity. These findings highlight the need for continued research into structural barriers affecting DO applicants in competitive specialties like ophthalmology.