The 2005 National Resident Matching Program (NRMP) Main Residency Match continued upward movement in the numbers of first-year and second-year graduate medical education positions offered and in the numbers of registered and active applicants. More positions were offered and more matches were made than ever before; however, the match rates for most categories of applicants and the fill rates in most specialties held steady, showing little variation from 2004. For the third year in a row, there was an increase in the number of applicants participating in the Match. Table 1 shows that 25,348 individuals submitted rank-order lists of residency programs, 102 more than the 25,246 who did so in 2004 and up by 1,889 (8.1%) since 2002. Of those 25,348 “active” applicants, 19,760 (78.0%) were matched to PGY-1 residency positions, an increase of 369, or 1.9%. The increase in applicants was accompanied by equally modest growth in the number of positions, with 24,012 first- and second-year positions offered in 2005 compared with 23,704 in 2004. Of those, 22,221 or 92.5% were filled, an increase of 409 (0.5%) over the 2004 Match (see Tables 2 and 3).Table 1: Participation in the 2005 National Resident Matching ProgramTable 2: PGY-1 Positions Offered and Filled by Specialty and Types of Applicants in the NRMP in 2005Table 3: PGY-2 Positions Offered and Filled by Specialty and Types of Applicants in the NRMP in 2005The single largest factor contributing to the increase in applicants was growth in the number of U.S. seniors. U.S. seniors submitting rank-order lists for the 2005 Match numbered 14,719, compared to 14,609 in 2004, 14,332 in 2003, and 14,336 in 2002. This was the second consecutive year since 1997 that the number of U.S. seniors rose over the prior year. The match rates (percentage of applicants who obtained positions) for most subgroups shown in Table 1 varied less than 1.0% from those of the 2004 Match. The sole exception was among foreign-born international medical school graduates (IMGs), whose match rate increased 3.2 percentage points. The 2005 Match was the first for which the new USMLE Step 2 clinical skills examination was required to obtain certification by the Educational Commission for Foreign Medical Graduates (ECFMG). IMGs who have not met the ECFMG's certification requirements are withdrawn from the Match. In the months leading up to the Match, many IMGs expressed concern about their ability to participate because of anticipated delays in score reports. The number of IMGs withdrawn in 2005 because they lacked ECFMG certification was 1,777, compared with 1,220 the prior year; however, the 2005 number is similar to the number of 1,713 IMGs withdrawn for the same reason in 2003 and the 1,687 in 2002. Still, the 5,554 IMGs who submitted rank- order lists was 117 fewer than last year, reversing an upward trend since the low point in 2002. Both the number of PGY-1 positions offered and the fill rate (percentage of positions filled in the Match) increased in 2005. The number of positions grew by 262 (1.2%) to 21,454, and the fill rate increased by 0.6% to 92.1%. This Match was the second in a row since 1999 that the fill rate was 90.0% or better. The largest growth in PGY-1 positions offered was 257 (23.9%) in Preliminary Surgery and 100 (5.3%) in Preliminary Internal Medicine. Both of those increases were due partly to heightened enforcement of a long-standing NRMP policy requiring programs to offer preliminary training to U.S. allopathic seniors only through the Main Match or another national matching plan. The number of positions offered in Pathology was up by 49 (10.3%) and the number in Emergency Medicine was up by 37 (3.2%). There were 21 (3.6%) more positions in Orthopaedic Surgery and 20 (4.5%) more in Anesthesiology. The largest decrease was again in Family Practice, down 103 positions in 2005 and a total of 532 positions since 1998. The number of PGY-2 positions offered in the 2005 Match increased by 46 (1.8%) over 2004 to 2,558, with 29 more in Diagnostic Radiology and 25 more in Dermatology. The number of Anesthesiology positions declined by 26. Of the 2,558 PGY-2 positions offered, 2,461, or 96.2%, were filled, 41 more than in 2004. The PGY-2 fill rates for 1996 and 2004 were 51.1% and 96.2%, respectively. Specialties’ fill rates by types of applicants are shown in Tables 2 and 3. Notable changes from 2004 include: ▪ General Surgery PGY-1: matched 40 fewer U.S. seniors with a fill rate that fell from 99.8% last year to 99.3% this year, reversing the upward trend that had begun in 2002. ▪ Preliminary Surgery: matched 146 more U.S. seniors and filled 166 more positions with a fill rate of 65.0%, nearly identical to last year. ▪ Emergency Medicine PGY-1: filled 35 more positions, matched 58 more U.S. seniors, and held its fill rate steady at 98%. ▪ Emergency Medicine PGY-2: filled all of the 144 positions offered and matched 120 U.S. seniors. ▪ Pediatrics: filled 43 more positions, took 64 more U.S. seniors, and increased its fill rate to 97.4%. ▪ Family Practice: filled 19 more positions, the second consecutive increase since 1997, resulting in a 3.6% increase in its fill rate. ▪ Anesthesiology PGY-2: filled 5 more positions with 15 more U.S. seniors for an overall fill rate of 96.5%, reversing last year's one-year decline in those numbers and being a remarkable change from the 1996 fill rate of 29.6%. ▪ Dermatology PGY-2: filled 21 more positions with 8 more U.S. seniors, for an overall fill rate of 98.3%. ▪ Physical Medicine and Rehabilitation PGY-2: filled 264 positions (95.0% of those offered) with 16 more U.S. seniors. ▪ Psychiatry: for the fourth consecutive year, more positions were offered (1,042) and more U.S. seniors matched (665). ▪ Generalist positions represent one half of all PGY-1 positions in the Match, with 10,565 offered in 2005. The generalist specialties are defined as Family Practice, Internal Medicine, Internal Medicine—Pediatrics, Internal Medicine—Primary, Pediatrics, and Pediatrics—Primary. Preliminary Medicine positions are not included. For the second year in a row and only the second time since the 1997 Match, those specialties—in the aggregate—matched more U.S. seniors than were matched in the prior year. Internal Medicine matched 57 more U.S. seniors and Pediatrics took 68 more than in 2004. Still, although the overall number of U.S. seniors matched to the generalist specialties was up by 15, the total remained less than half (43.1%, or 5,945) of all U.S. seniors who matched to first-year residency positions. ▪ The number of applicants who entered the Match as part of a couple was 1,212 this year, the second highest number ever. Couples continued to experience success, with match rates above 90% since 1984 and a 2005 match rate of 94.3%, 0.4% higher than in 2004. Two partners identify themselves as a couple to the NRMP and submit rank-order lists of identical length. The algorithm treats the two lists as a unit, matching the couple to the highest linked pair of program choices where both partners match to the programs listed. The vast majority of couples are U.S. seniors, and their match rates are similar to those of their classmates, varying within one or two percentage points each year.
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Signer et al. (2005) studied this question.