Going through the Match process, and the subsequent Supplementary Offer and Acceptance Program (SOAP) window, without landing a residency position is certainly a deep disappointment. But it should not put an end to your dream of practicing as a certain type of physician.
It does require a reexamination, however, of where you stand as a residency applicant and how your skills, background, experience and performance align with your preferred specialty. And it may require some recalibration and reconsideration of potential career paths. One area in which many Match reapplicants must do an honest assessment is specialty choice.
2025 Match data put together by the National Resident Matching Program looks at outcomes for U.S. MD and DO graduates. Defined as anyone who is applying for a residency position in a Match year other than the one during which they graduated medical school, this U.S. MD and U.S. DO graduate category is the classification under which reapplicants generally fall. What does the data say and how should it inform your reapplication strategy?
The landscape for MD graduates
People who are reapplying to the Match are going to face longer odds of matching than they did the first time. The 2025 Match featured 1,751 active applicants who applied as U.S. MD graduates. Applicants applying for residency the same year they are expected to graduate medical school are considered U.S. MD or U.S. seniors.
In 2025, the Match rate for U.S. MD graduates was roughly half the rate for U.S. MD seniors.
Still, there are some encouraging data points. Chief among them is that residency programs—even those in physician specialties considered to be more competitive—don’t by any means disqualify U.S. MD graduates from landing residency positions. Looking at the 2025 Match, the specialties with at least 50 PGY-1 positions offered in which MD graduates made up the largest portion of matched applicants were:
- General surgery—8.3% of positions filled by U.S. MD graduates.
- Neurological surgery—5.2%.
- Orthopaedic surgery—4.6%.
- Diagnostic radiology—4%.
- Obstetrics and gynecology—3.2%.
- Pathology—3.2%.
In terms of raw numbers, the largest total of U.S. MD graduates matched internal medicine, with 148 doing so. Still, that figure only represented around 1% of applicants who matched in that specialty. Compare that with general surgery, in which 147 MD graduates matched and made up more than 8% of the matched applicant total.
Narrower options for DO grads
With 630 active applicants. U.S. DO graduates were far less common than MD graduates in seeking positions as part of the 2025 Match. The Match rate for U.S. DO graduates 43.8%, was nearly 50 percentage points lower than the match rate for U.S. DO seniors (92.6%).
The specialties with at least 50 PGY-1 positions offered in which DO graduates made up the largest portion of matched applicants were:
- Diagnostic radiology—2.6%.
- General surgery—2.1%.
- Interventional radiology (integrated)—1.9%.
- Emergency medicine—1.1%.
- Ob-gyn—1.1%.
- Pathology—1.1%.
Family medicine was the specialty with the most U.S. DO graduates matched (52), followed closely by internal medicine (51), surgery (37) and emergency medicine (35).
What the data means for reapplicants
Even if the data is encouraging for some of the more competitive specialties for reapplicants, if the goal is matching after missing out the first time around, it might help to broaden your application parameters. That could include casting a wider geographic net or looking at another specialty. It’s also important to review each aspect of your application and understand any weak points.
Liz Southworth, MD, has studied the Match and been part of reviewing applications as a chief administrative resident during her final year of training as an ob-gyn resident and, more recently, in her current position as a urogynecology fellow.
Not matching “is a black box for many reasons,” Dr. Southworth said. “It's so individualized. The experience of a single applicant is going to be drastically different than the other applicant who doesn't match depending on specialty, geography and a number of other factors.”
Because of that, she said, guidance from a mentor is key.
“Reach out to mentors who helped with your initial application,” she said. “They can help you the second time by reevaluating your application and looking at the list of programs you plan to apply to.”
Beyond that, Dr. Southworth said, it’s important to make the most of your gap year.
“As someone who has looked at residency applications at two institutions, I can tell if you have a lapse or are switching [specialties]. We really are looking for some evidence of growth, learning, reflection,” she said. “How did your time, that year in between, help you clarify what your goals were and build additional skills?”
