What’s the news: Continuing a multiyear trend, the 2022 Main Residency Match included the largest number of total positions on record: 39,205.

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Among the total positions, 36,277 were post-graduate year 1 (PGY-1) positions, also marking the largest number of those positions in Match history. It’s a 3.1 percentage point increase over 2021 and the growth was spurred, in part, by more programs offering PGY-1 positions in the Match.

There were an additional 177 programs with PGY-1 positions this year, a 3.4% increase over 2021’s Match. Positions in emergency medicine, family medicine, psychiatry and internal medicine contributed to those growing numbers.

Why it’s important: Fill rates remained high in the 2022 Match and match rates were higher for nearly all groups. There was a 94.2% fill rate for the 39,205 total positions offered this year. Among the 36,277 first-year positions offered, there was a 93.9% fill rate. That is less than a 1 percentage-point decline from 2021.

In addition to the largest number of total and first-year positions offered, “the 2022 Match realized many significant milestones including a record number of U.S. MD and U.S. DO senior applicants,” said Donna L. Lamb, president and CEO of the National Resident Matching Program (NRMP).

“While all categories of applicants saw improvements over 2021, U.S. DO seniors achieved a 91.3% match rate, a 2.2 percentage-point increase over last year, the highest on record for that group of applicants, and a rate on par with the match rate achieved for U.S. MD seniors,” Lamb said.

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American Association of Colleges of Osteopathic Medicine (AACOM) officials noted that the U.S. DO seniors who participated in the Match was a record-high 7,303 this year, an increase of 2.8% over 2021. Among those students, 6,666 matched to first-year residency positions, a 5.4% increase from last year and also a new record high. 

Robert Cain, DO, is AACOM’s president and CEO, and said he was “particularly pleased to see that osteopathic medicine continues to grow. We saw DO applicants fill a larger piece of the overall residency pie than ever before and with another record number of graduates, we saw the match percentage numbers rise as well.”

An additional 78 MD senior applicants participated in the Match this year.

There were 1,433 fewer U.S. citizen and non-U.S. citizen international medical graduates (IMGs) who registered for the 2022 Match, compared with the 2021 Match. Pandemic concerns revolving around travel regulations and possible COVID-19 variant strain outbreaks could explain the lower participation rates, NRMP officials said. Still, the PGY-1 match rate for U.S. citizen IMGs rose 1.9 percentage points to 61.4%. For non-U.S. citizen IMGs, the match rate increased 3.3 percentage points to 58.1%.

Find out how the AMA International Medical Graduates Section advocates on the issues that affect IMG physicians.

Overall, the Match included 47,675 registered applicants this year, down 2.1 percentage points from last year. There were 42,549 active applicants, which means those applicants who submitted certified rank-order lists. At a rate of 80.1%, 34,075 of active applicants matched to PGY-1 positions, a 1.6 percentage point increase over 2021.

Some physician specialties that increased the number of positions offered in the Match this year saw a drop in the percentage of positions filled this year compared to 2021: 

  • Emergency medicine, fill rate down 7 percentage points.
  • Family medicine, down 2.7 percentage points.
  • Internal medicine, down 0.7 percentage points.
  • Psychiatry, down 0.6 percentage points.

The change in emergency medicine “could reflect changing applicant interests or projections about workforce opportunities post-residency,” NRMP officials said in a press release. They also noted that the specialty has grown considerably “over time, having added 643 positions since 2018, an increase of 28.2%.”

Primary care saw a record number of positions offered in the 2022 Match. There were 36,277 first-year positions offered, 484 more than offered in 2021, a rise of 2.7%. Among the positions, 94.4% were filled, with 64.6% of the positions filled by U.S. seniors.

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While the percentage of primary care positions that U.S. seniors filled in 2022 shows a 0.7% decline from 2021, U.S. DO seniors saw a gain in the number matched:

  • Pediatrics, 61 positions, up 11.8%.
  • Internal medicine, 120 positions, up 8.1%.
  • Family medicine, 54 positions, up 3.6%.

Applicants who did not match to a residency position participated in the NRMPMatch Week Supplemental Offer and Acceptance Program (SOAP). This year, 2,262 positions were unfilled after the matching algorithm was processed—335 more than last year. SOAP results will be available in the full Match report scheduled to be published in early May.

Learn more: If you’re among those who matched this year, the AMA offers great advice and resources on the next steps to get ready for your transition to residency.

If neither Match nor SOAP landed you the residency position you were hoping for, check out this great advice about three things to do if you don’t match.

If you are preparing for next year’s Match, check out the AMA’s new “Road to Residency” series for more timely, relevant information.

And find out the AMA Resident and Fellow Section gives voice to, and advocates for, the issues that affect resident and fellow physicians.

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