There was a fear of potential calamity associated with the 2021 Main Residency Match. Away rotations and in-person interviews were not options, and medical students would be applying to programs in venues they may never have set foot in.

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Still, when all was said and done, even with major disruptions, the 2021 Match was the largest on record and the results were largely similar to previous years.

A recent AMA Innovations in Medical Education webinar, "The residency application and match process: Reflecting back, thinking forward,” examined the most unusual Match in modern history.

Here’s a look at how medical education—on both the graduate and undergraduate levels—made it work.

The concern: With interviews taking place online and diminishing time and travel as factors, would a small group of medical students hoard interview spots?

The reality: Medical schools encouraged students to try to limit their interview exposure to only those institutions in which they were interested.

According to webinar presenter Julie Story Byerley, MD, MPH—vice dean for academic affairs at the University of North Carolina at Chapel Hill School of Medicine—a similar number of interviews were offered to applicants, but more were completed.

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2021 Match hits record highs despite pandemic’s disruptions

Anecdotally, she said, some residency program directors were more risk averse and more likely to invite their own students.

“The bottom line in lots of student-affairs encounters that I talked with was that things worked out,” she said. “Not much different than in the past. But the emotional toll was heavy.”

The concern: Medical students would have a harder time committing to a program without visiting in person.

The reality: Residency programs had to increase their online presence. They created new social media accounts, webpages and recruiting videos.

“Everybody worried about how to replicate the important interactions that take place at social events and to ensure faculty were prepared to one-on-one interview,” Dr. Byerley said.

The concern: The Match rate would dip considerably in a disrupted cycle. This caused the National Resident Matching Program to add an extra round to the Supplemental Offer and Acceptance Program.

The reality: The Match rate fell nominally for seniors graduating from U.S. MD- and DO-granting medical schools—a 0.9% decrease for MDs and a 1.6% dip for DOs relative to last year. Still, in those segments the number of students who actually matched rose compared with last year, by 327 and 359 more, respectively. The largest dip was in non-U.S. citizen graduates of international medical schools, which saw a 6.3% decline in Match rate.

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Q&A: Pandemic’s lasting impact on the future of residency selection

“We went into survival mode, and thought that as long as people match, as long as programs fill, that was going to be OK,” Dr. Byerley said. “But that survival-mode mindset didn’t last long before the angst set in.

We need to figure out what we learned through this process, what [innovations] we should keep. And we have to figure out ways to decrease the stress associated with the process.”

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.

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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