The 2025 appointment-year fellowship Match represented the largest on record once more, with data released by the National Resident Matching Program (NRMP) providing more in-depth information on the types of physicians filling positions in Matches conducted in 2024 and early 2025 for programs in 77 subspecialties.
Figures released by the NRMP show 14,620 fellowship positions offered in the Specialties Matching Service (SMS), an increase of 451 positions. Of those, 12,390 (84.7%) were filled, up from 83.7% in 2024. Some subspecialties added more positions, but the addition of interventional cardiology to the SMS was responsible for much of the increase, NRMP data shows. The subspecialty joined the Medicine and Pediatrics Match for the first time in 2025, offering 326 positions, of which 272 (83.4 %) were filled.
In 2025, 6,808 U.S. MD graduates matched, and among U.S. DO graduates, 1,935 matched. The latter figure was up by 128 from 2024, according to the fellowship Match outcomes data available on the NRMP website. Of those who matched, 1,350 were U.S.-citizen international medical graduates (IMGs) and 2,252 were IMGs who are citizens of countries other than the U.S.
“These statistics bring more transparency and understanding for medical school students and residents looking to pursue fellowship,” said NRMP President and CEO Donna L. Lamb, DHSc, BSN. “The data gives insights into how their applicant type fares in different specialties.”
Variation among subspecialties
Certain subspecialities were more likely to match with certain types of applicants, according to NRMP data. Of the subspecialties offering at least 30 positions, complex family planning had the highest percentage of positions filled by U.S. MD graduates, at 100%. Nephrology had the lowest, at 24.6%.
Other subspecialties with high percentages of positions filled by U.S. MDs included:
- Pediatric surgery—91.8%.
- Minimally invasive gynecologic surgery—89.4%.
- Reproductive endocrinology—89.3%.
- Female pelvic medicine and reconstructive surgery—88.6%.
The five subspecialties with the highest percentages of positions filled by U.S. DO graduates were:
- Sports medicine—41%.
- Emergency medical services—31.6%.
- Child abuse pediatrics—30%.
- Pain medicine—29.7%.
- Pediatric rheumatology—29.6%.
The five subspecialties with the highest percentages of positions filled by U.S. IMGs were:
- Critical care medicine—22.8%.
- Geriatric medicine—21.3%.
- Interventional pulmonology—20.9%.
- Addiction medicine—19.2%.
- Clinical cardiac electrophysiology—18.8%.
The five subspecialties with the highest percentages of positions filled by non-U.S. IMGs were:
- Medical genetics—54.5%.
- Endocrinology, diabetes and metabolism—38.7%.
- Nephrology—36.2%.
- Interventional cardiology—34.2%.
- Rheumatology—34.2%.
One way to think about competitiveness in a subspecialty can be the share of U.S. MDs and DOs who match, Lamb said. The traditional thinking is that the lower those match rates are, the more competitive the subspecialty. But, she noted, there are other ways to evaluate the relative competitiveness of a fellowship program.
“We consistently see higher MD-graduate fill rates—greater than 50%—in specialties like gastroenterology and cardiovascular disease, some of the radiology specialties, and most, if not all, of the surgical specialties,” Lamb said. “But that consideration should be tempered with the understanding that MD graduates are by far the largest applicant pool.”
She also said that fill rates, independent of applicant type, can present another marker of competitiveness. Some of the specialties with high fill rates were:
- Allergy and immunology—98.8%.
- Endocrinology—98.4%.
- Pulmonary/critical care medicine—97.3%.
- Pediatric critical care medicine—98.7%.
“Fellowship applicants should consider competitiveness from a variety of perspectives when considering where to apply,” Lamb said.
Resident physicians interested in applying to fellowship programs should consult FREIDA™, the AMA Residency and Fellowship Database®, which offers users the opportunity to explore more than 7,300 fellowship programs accredited by the Accreditation Council for Graduate Medical Education. Users can narrow their search by location (list or map view), application information, benefits and special tracks.
For the 2026 Electronic Residency Application Service (ERAS) fellowship-application season, those taking part may begin submitting applications to programs Nov. 12, 8 a.m. CST.
Going beyond the data
Perspective is recommended when examining the data, experts say. For example, Lamb said, the fellowship Match is roughly one-third the size of the Main Residency Match in terms of positions offered. And many fellowship programs offer only a small number of positions, meaning that even minor numerical changes year over year can greatly affect percentages. For example, pediatric transplant hepatology only included 15 positions, of which 14 were filled.
“It's hard to say uniform things about fellowship matches because it's such a diverse universe,” said John Andrews, MD, vice president of graduate medical education innovations at the AMA.
He also pointed out that the Match data doesn’t capture how many applicants to a particular program were MDs or DOs, for example, or what the Match rate percentage is from those applicant classes.
“Importantly, it also doesn't reflect the distribution of those applicant types in the residency programs that will render them eligible for these fellowships,” he said.
The most useful information about the relative competitiveness of programs, Dr. Andrews said, often comes from the physicians practicing in the subspecialties.
“For residents seeking fellowship positions, people with expertise in the area that they're seeking further training in—[especially those] who work with them, who they have access to locally—are going to be really important sources of information,” he said.
“Because the specialty communities around each fellowship are small, the people who practice in these areas know one another,” Dr. Andrews added. “Those connections and that opportunity to understand where your professional development goals are going to be best fulfilled in fellowship training really depend critically on those sources of advice.”
Not matching
About 91% of U.S. MD applicants seeking fellowships found a match through the NRMP Specialties Matching Service in 2025, compared 82.4% of U.S. DO applicants. For those not matching, such a setback may be a disappointment, but it’s important to keep the matter in perspective, Dr. Andrews said.
“By definition, people who are applying for fellowship are knowledgeable physicians,” he said. “They will have many opportunities to practice medicine in a variety of settings. To not match to a specific subspecialty training program may lead them to try to match again in a different year or find a different way to apply their skills. Not matching may limit your options to work in a highly specialized area, but you still have those skills as a physician to use in so many ways.”
Learn more with the AMA about how resident physicians can bolster their fellowship Match qualifications, and find out the top factors that fellowship program directors look for in fellowship applicants.
— Senior News Writer Brendan Murphy contributed to this report.
