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AMA Update
Class of 2023 Main Residency Match results: data and trends with NRMP's Donna Lamb, DHSc
Mar 23, 2023
Featured topic and speakers
In today’s AMA Update, National Resident Matching Program's Donna L. Lamb, DHSc, breaks down the numbers from this year's residency Match. Discussing Match rates, changes by specialty, SOAP results and what's in store for Class of 2024 Match Day.
This special Match Day edition also includes interviews with medical students and footage from UIC's 2023 Mach Day event—recorded live at the University of Illinois College of Medicine at Chicago. AMA Chief Experience Officer Todd Unger hosts.
Speaker
- Donna L. Lamb, DHSc, president and CEO, National Resident Matching Program
Unger: Hi, it's Todd Unger, chief experience officer at the AMA, and we've got a special AMA Update for you today. We're live at UIC's Match Day Celebration. And we are celebrating along with 200 medical school students and their families as these med students find out just what's next for them.
How are you feeling today?
Gabrielle Perez: It hasn't fully hit me, but now the nerves are starting to set in. And so, reflecting back on the past four years and everything, it's just like a whirlwind of emotions starting to kind of come hit me all at once.
Max Ellithorpe: I'm just excited and kind of in disbelief that it's finally here.
Robert Barish, MD, MBA: This group has been through COVID more so than any other group. And look at them now smiling and just joyful. I'm so proud of them.
Kyleen Jan: Yeah. I'm the first one in my family to go to medical school and become a doctor, so it's really exciting for everybody—just very excited to see where I'm going to be for the next five years, excited to start taking responsibility for my patients, become an orthopedic surgeon, and do good things for my patients.
Sri Raghurama Somala: So, I was born in India kind of to a family of farmers, came here in third grade.
Unger: So, is this kind of a dream for you today?
Somala: A little bit but becoming more of a reality. So, I've got to keep pinching myself to make sure I'm awake. I just hope I don't wake up in my bed in like an hour or so knowing this is all a dream.
Gaia Santiago: We're hoping to match together in plastic surgery today, so we'll see.
Chiara Santiago: We have gone through every school together—middle school, elementary school, high school, college, medical school, if I did not say that already. So, we'll see. We'll see if residency is the first school to tear us apart.
Unger: How are you feeling today?
Gaia Santiago: I'm nervous. I'm more nervous than she is. But she's calm, and I'm just excited to find out, but definitely a little nervous.
Ana Gonzalez: So nervous. We find out at 11:00. We're couples matching so we're trying to stay together. We're really excited. Honestly, we are going to be happy as long as we're together, so I just hope that we are together and that we build a life and settle down and make the most of it.
Unger: I wish you both the best, and we'll see you after this.
Ben Aronson: Thank you so much.
Gonzalez: Thank you so much. Thank you.
Mark Rosenblatt, MD: To this Class of 2023, I wish you success in your practice of medicine and all of your future endeavors. With you at the helm, we know that the future of medicine is bright. We are so very, very proud of you. And so, please, let's give a round of applause to this wonderful group.
Unger: All right. This is an exciting moment. All of the medical school students are up here collecting their envelopes with the match that will tell them what the future holds for each of them. And at precisely 11:00, they're going to all open them up together and see just what the future has in store.
Speaker: The moment is here. 10, 9, 8, 7, 6, 5, 4, 3, 2, 1. Congratulations.
Unger: All right. How did it turn out?
Gonzalez: We got our number one choice, Northwestern and UChicago.
Aronson: I'm like at a loss for words. It's so much work and thought goes into this process and, ultimately-
Gonzalez: Oh, my gosh.
Aronson: We got our number one so—
Gonzalez: We get to stay in Chicago. We don't have to move. We're going to be here.
Aronson: And a privilege is to continue to serve these patients. It's just something about it, it's just special. I love this city, and it's like I'm at a loss for words right now. But it's—
Gonzalez: I'm so grateful for everything my family has done to help me get to this point. My grandfather and my grandma, and I'm thinking of you guys, yaya and abuelo.
Unger: I got to know, did the universe tear you apart, or did the universe come through?
Chiara Santiago: We're not in the same school, but the same city, thank God.
Gaia Santiago: We're both in Chicago.
Chiara Santiago: Yeah.
Unger: How are you feeling about that?
Gaia Santiago: So happy.
Jacob Bruinius: I match at the University of Michigan for anesthesiology.
Unger: Congratulations. How are you feeling about this?
Bruinius: I'm feeling really excited. This is awesome.
Unger: How are you feeling right now?
Chiaka Anyaso: Man, over the moon, just overwhelmed with emotions, very grateful. I feel blessed, and I'm very proud of myself.
Unger: You got to be pretty proud of this graduate.
Chiaka Anyaso mother: Very, very proud. I'm so proud of her. She worked hard and it paid off. So, I'm so proud of her. And I thank God, too, that made it possible.
Unger: Congratulations. All right. I got to know, how'd it turn out?
Joseph Geraghty: Amazing, going to University of Pennsylvania in Philly. It's my number one choice. I'm super excited.
Unger: Excellent, congratulations.
Amy De La Torre: I'm ecstatic. I honestly have no words. I'm still shaking. Look at my hands. My family, all my loved ones are here so it was an incredible moment. Definitely one of the most memorable times of my life. So—
Unger: We got to find out, was it a dream or not?
Somala: I'm still awake, so it doesn't seem like it's a dream. I'm doing internal medicine in Nashville, so let's go.
Unger: And tell us the big news. Where'd you match?
Regina Koch: I matched at the Mayo Clinic in Rochester. Woo!
Unger: I guess I can tell, but how are you feeling?
Koch: I'm excited. I'm really happy. I'm excited, hoping to go into hematology oncology. So, we are thankful and grateful today.
Unger: Well, gosh, I have to take a moment to collect myself. That was a really moving experience to be able to celebrate Live Match Day at UIC here in Chicago. You can just feel the energy in the room as the students opened up those envelopes and they found out where they were going to be going, and you just hear these cheers, and just see all the families’ reactions. It was just—it was amazing. Thank you, UIC, for letting us join you.
And now, I am joined by a special guest, Dr. Donna Lamb, president and chief executive officer of the National Resident Matching Program, or NRMP, in Washington, DC, for a broader discussion about this year's Match—what went well, what we learned, and if it looked like a more pre-pandemic Match this year. Dr. Lamb, thanks for joining us today.
Dr. Lamb: Todd, it's so good to see you. Thank you for having me on the podcast. And we, too, enjoyed watching those Match celebrations as they occurred across the country. They're just—they're heartwarming, for sure.
Unger: They are. And it's funny, we talked last time in April of 2021 how much has changed since then, and just what a pleasure to be back in person and to be able to see that. So, let's start off with kind of at the high level with participation levels. Can you tell us a little bit about the level of participation in the Match this year, and how it compared to previous years?
Dr. Lamb: Sure. Participation in the Match was high. And that really wasn't surprising to us given the ACGME's report of new program accreditation and physician accreditation being higher than expected throughout the pandemic. But specific to this year's participation, there were 6270 programs offering a total of 40,375 positions.
And this is an increase of about 3% from 2022, which is amazing. When we look at applicants, we look at them in two ways. First, who registered for the Match. And then, who was active in the Match, or who certified a rank order list.
And so, we saw about a 1% increase in the number of registered applicants. There were 48,156. But a little unexpected was the majority of the gain in the applicant numbers for non-U.S. citizen international medical graduates. They saw an increase of over 700 applicants.
And then osteopathic seniors saw an increase of over 150 applicants. So, we saw a slight decrease, though, this year in USMD seniors, about 236 less, that registered for the Match this year than in prior years. Then when we look at—I mentioned the active applicants, they're the ones who completed and certified a rank order list.
We saw an overall increase in active applicants of about 403, bringing us to about 42,952 active applicants. So, it was a good size Match.
Unger: It was. And how did this level of participation influence the overall Match rates for applicants and the program fill rates?
Dr. Lamb: Well, when we ran the algorithm of those 40,375 positions that were offered, 93%, or 37,690, of those positions filled. And that includes both the PGY1 and the PGY2 positions. And that 93% is in line with historic Match rates.
Then if we look at just the PGY1 positions, about 34,822 applicants matched. And that was an increase of 747 applicants over the 2022 main residency Match. So, the PGY1 Match rate went up just a little bit from 80.1% in 2022 to 81.1% in 2023. So again, a good outcome.
Unger: Now, I'm going to say, in the six years I've been here at the AMA, I don't think I've ever read about Match rates in all of mainstream newspapers. But there are stories this week about certain specialties that maybe fared better than others this year. Talk to us a little bit about what you see driving those kind of different match rates.
Dr. Lamb: All right. Well, let's talk a little bit about the numbers again, if you don't mind, Todd, because I want to talk about who did well this year, as well as who is in the news, to your point. Internal medicine did great this year. They filled at 96%. And that's been a slight increase over the previous three years. So internal medicine continues to draw applicants from all of the different cohorts of applicant types— international medical graduates, U.S. seniors, and graduate applicants.
Pediatrics and psychiatry remained consistently high with 97% and 99% fill rates, respectively. And then, of course, the historically competitive specialties that include general surgery, anesthesia, neurosurgery, OB/GYN, orthopedic surgery, they all continue to fill at very high levels. But there are a few specialties where we had some interesting findings.
Diagnostic radiology, who saw a dip in Match rates in 2020 went all the way down to 94.3%, has now seen a match rate of 100% over the last two years. And so that may indicate that it's sustaining a competitive stance as a specialty. And, of course, interventional radiology also continues to Match at a very high rate. Again, at 100% this year.
But two specialties that had some declines this year—family medicine. Family medicine filled at 88.6% this year, and that was a decrease of two percentage points from last year. And this could, potentially, be a red flag.
I know we always talk about family medicine and their fill rates and where they're filling across the country, but this specialty has seen a year-over-year decline in their Match rate over the previous five years. And this is representing about an 8% percentage point decrease in Match rate for family medicine since 2018. So, we really do need to pay attention to that specialty.
To your point in the news, this Match cycle is emergency medicine. They saw a decline in their Match rates for the second year in a row. This year's Match rate was 81.6%, and that's an 11 percentage point decrease from the positions that were filled in 2022.
At the end of the Match when the algorithm was run, there were 554 positions remaining unfilled. So that was, obviously, a concern to the emergency medicine community. But the silver lining is that at the end of the supplemental offer and acceptance period, which ended last Thursday, all but 44% of those positions of the 554 positions were filled. So ultimately, emergency medicine had a higher fill rate. But certainly, the specialty needs to understand what's happening to be able to address the needs of the new physicians entering the field.
Unger: Absolutely. And thankfully, we've largely emerged from the acute phase of the pandemic. In-person learning activities, including clinical rotations, have fully resumed. Did this help relieve any of the challenges that students and programs have experienced over the past couple of years?
Dr. Lamb: Oh, yeah, that's so hard to say, Todd. Medical education is certainly starting to more fully engage in the way that it did before the pandemic. But the health care environment and the learning environment have fundamentally changed. And so medical education is still working to adapt to those changes.
But one example of a specific—or of the shift that's specific to the transition to residency, if I may, one thing that helped to alleviate some of the stressors include that shift to virtual interviews. So, this was an important shift that is affecting applicants and program. But it's a shift that appears to be really valuable for applicants, mostly due to the decrease in costs, which has a direct impact on their student debt, decreasing the associated stress of having to schedule travel, as well as take time away from their fourth year clinical rotations.
But there are also cons, right? Applicants are trying to work through learning what's the pulse of the program, what's their mission, what's their culture, what's their vibe, what's the community like. And, of course, programs who have, for the most part, retained virtual interviews also have very mixed feelings about them.
There are tangible and intangible cost improvements in the interview cycle. But in-person interviews help to enhance the program's ability to showcase their program, their organization, their community. And, frankly, programs indicate that they find it easier to assess an applicant in person. So, some things have been alleviated, and some things are still yet to be seen.
Unger: I think we're all learning ourselves through that particular balance right there. Doctor, several specialties allowed applicants to signal programs their preferences and provide more information about themselves in terms of past experiences, geographic preferences, things like that. Do you think that helped programs and applicants in the Match process?
Dr. Lamb: This is a great question and, unfortunately, one that we really don't know the answer to yet. Preference signaling in its current form only allows applicants to send a signal of interest to programs where they want to interview. So, it's not a signal of their desire to either rank or match with a program.
And so, to date, otolaryngology is the only one who has substantially published their preference signaling outcomes. And they're reporting that they're relatively positive in terms of seeing a more diverse candidate pool and seeing applicants that they might not have otherwise. But our team has studied the first year otolaryngology's preference signaling data to see if the impact on the interview selection carried over to the ranking and matching behavior.
In other words, did the more diverse pool of applicants translate into a more diverse pool of trainees? And when we looked at that first year's data, and again, it's only the first year's data, it really didn't translate. There really wasn't a change in the patterns of ranking and matching.
But again, we keep in mind that this is the first year's data. We wouldn't expect to see immediate changes, and we really look forward to working with all of the specialties to better understand how preference signaling might be impacting, not only their interview, but their ranking and matching behaviors.
Unger: Now, you mentioned SOAP earlier, and that's Match Week's Supplemental Offer and Acceptance Program. How'd it go this year? Anything that stands out to you in particular?
Dr. Lamb: Well, the process for extending applications, engaging in interviews, and offering positions went very, very smoothly, which we were all pleased with. This year there were 2,685 positions unfilled after the algorithm were run. And of those positions, 2658 were placed in SOAP.
So consistent with historical trends in SOAP, we saw about 51% of those positions were offered and accepted during the first round, 75% by the end of the second round. And at the end of the fourth round, there were about 227 positions that remained. So about 91% of the available positions in SOAP were filled.
And then when you put that together with the main residency Match rate, that brought the full Matching cycle to around 99% of the programs that were offered at the beginning of Match ended up being filled. So, we were quite excited about it. So that stands out to us, for sure.
Unger: Well, it does sound—you should be really pleased based on those results.
Dr. Lamb: Yeah.
Unger: Where do you see the biggest opportunities kind of going forward based on what you learned this year?
Dr. Lamb: Right now, I think our biggest opportunity is to continue to try and figure out where we can continue to reduce stressors. So right now, we are looking at a proposal that came from the community. We actually have a call for public comment out.
The community has indicated that they would like for programs to be able to voluntarily lock their rank order lists a couple of weeks prior to the applicants, so that those applicants who have virtual interviews would have an opportunity to come and visit the program before they certify their own rank order list, knowing that the program has already selected their rank order list and certified their list. And then we're looking at whether or not we should change that timeline in Match Week. I'm hesitant to do so, to be honest with you, because I feel like right now, we have a fairly good process.
But there are folks who are still asking us to consider moving the Match Status Notification, that did I match or not notification, to the week before Match Week. And there's pros and cons to that. We're going to be talking to various constituents, the Council of Deans Programs, about how they feel about that possibility.
But those are two things where we can assess whether or not we can continue to alleviate stressors. And those right now are where we're looking to improve the transition to residency process.
Unger: Well, I love the continued innovation here. So just a huge shout out to you and the entire NRMP team. I know this has been kind of Super Bowl week for you this past week, and very exciting. Take a quick breather and then get ready for next year. It keeps happening.
That's it for today's episode. Dr. Lamb, again, thanks so much. It's good to see you here. I'll see you back in a year, and we can talk about next year's Match, too.
That's it for today's episode. If you want to catch all our videos and podcasts, you know where to find them, ama-assn.org/podcasts. Thanks for joining us today. Please take care.
Dr. Lamb: Thanks for having me, Todd.
Disclaimer: The viewpoints expressed in this podcast are those of the participants and/or do not necessarily reflect the views and policies of the AMA.
