First-Year Residents Who Began Their Graduate Medical Education in 2009–2010 and Found Their Positions Within and Outside the NRMP Match

PURPOSE: Analysts who assess trends in medical specialty choice often use statistics published by the National Resident Matching Program (NRMP), but a substantial minority of new residents find their positions outside of the NRMP. Rule changes to be implemented by the NRMP in 2013 may have a substantial impact on this behavior.The author quantified and characterized residents who found their positions outside of the NRMP. Using available data, the author was able to distinguish those who were unsuccessful in the NRMP from those who did not register and those who registered but failed to enter a rank order list of preferred programs. METHOD: NRMP data on applicants in 2009 (n = 36,971) were combined with data from the national resident census contained in the GMETrack system on residents who began their graduate medical education in 2009-2010 (n = 25,432). Residents were classified into categories based on their participation in the NRMP and their success in matching to a position, and by the type of medical school from which they graduated. RESULTS: Applicants who matched in the NRMP were 79.8% of new residents in first-year residency positions (n = 20,287). An additional 5.2% (n = 1,325) participated in the NRMP but were unsuccessful in matching. Aside from a small number of military residents, the remaining 13.7% (n = 3,488) found positions without participating in the NRMP Match. CONCLUSIONS: Workforce studies that rely on NRMP statistics alone to establish national trends are seriously deficient.