U.S. Medical School Graduates’ Placement in Graduate Medical Education: A National Study

Abstract Purpose This study describes graduate medical education (GME) placement outcomes for recent U.S. medical school graduates and examines racial and ethnic differences in GME placement among these graduates. Method This retrospective, observational study used data collected from and about U.S. medical school graduates for academic years 2015-2016 through 2021-2022. An individual-level, deidentified database was constructed to examine GME placement at graduation in association with race and ethnicity, as well as other demographic and academic and professional development variables. Multilevel (nested by school) logistic regression models identified variables independently associated with GME placement at graduation, reporting unadjusted odds ratios (UORs) and adjusted odds ratios (AORs) with 95% CIs. Results The study sample included 140,072 of 140,073 eligible graduates (> 99.9%; 1 graduate missing gender information was excluded), of whom 136,022 (97.1%) were placed in GME at graduation. Proportions of graduates placed in GME varied by race and ethnicity and by each covariable examined. In addition, proportions of graduates placed in GME varied by school (N = 152; mean SD, 96.9% 3.4%; P < .001). In multilevel (nested by school) models, GME placement UORs were lower for (among other groups examined) Asian (UOR, 0.76; 95% CI, 0.70-0.83), Black or African American (UOR, 0.44; 95% CI, 0.39-0.49), and Hispanic (UOR, 0.70; 95% CI, 0.60-0.80) graduates (vs White). The GME placement AORs, adjusted for all covariables, were similar for Asian (AOR, 0.96; 95% CI, 0.87-1.07), Black or African American (AOR, 0.89; 95% CI, 0.77-1.02), and Hispanic (AOR, 1.06; 95% CI, 0.89-1.25) graduates (vs White). Conclusions The proportion of graduates placed in GME at graduation during the 7 years of the study was high. However, there were racial and ethnic differences in this outcome during the study period.