Press Release: NRMP Delivers Strong Residency Match During Uncertain Times

Applicants Celebrate the 2021 Main Residency Match, Largest on Record

Washington, D.C., March 19, 2021 – Today the National Resident Matching Program® (NRMP®) celebrates Match Day with the thousands of applicants and programs participating in the 2021 Main Residency Match®. Medical school students and graduates from the United States and around the world have learned in which U.S. residency programs they will train for the next three to seven years. Results of the 2021 Main Match are highly anticipated given the pivot this year to a virtual recruitment season resulting from the COVID-19 pandemic and the effect it might have on the Match.

“The NRMP is honored to have delivered a strong Match to the many applicants pursuing their dreams of medicine. We admire all the Match participants for their hard work and their commitment to train and serve alongside their peers,” said Donna L. Lamb, DHSc, MBA, BSN, NRMP President and CEO. “The application and recruitment cycle was upended as a result of the pandemic, yet the results of the Match continue to demonstrate strong and consistent outcomes for participants.”

Largest Match on Record: Outcomes Flourish Despite Pandemic

The 2021 Main Residency Match was the largest in NRMP history. There were 38,106 total positions offered, the most ever, and 35,194 first-year (PGY-1) positions offered, an increase of 928 (2.7%) over 2020. The growth in positions was supported by continued growth in the number of Match-participating programs. A record-high 5,915 programs were part of the Match, 88 more than 2020. In five years, the number of Match-participating programs has increased by 845 (16.7%), spurred in part by the completion of the transition to the single accreditation system for allopathic and osteopathic programs.

Rather than faltering in these uncertain times, program fill rates increased across the board. Of the 38,106 total positions available, 36,179 filled, representing a 2.6 percent increase of filled positions over 2020. Of the 35,194 first-year positions available, 33,535 filled, representing a 2.9 percent increase of first-year filled positions. Those fill rates drove the percent of all positions filled from 94.6 to 94.9 percent and the percent of PGY-1 positions filled from 94.6 to 94.8 percent in 2021. There were 1,927 unfilled positions after the matching algorithm was processed, a decline of 71 (3.6%) compared to 2020.

Applicant Achievement

Growth in Match Participation Drives More PGY-1 Placements. The number of applicants who registered for the 2021 Main Residency Match reached an all-time high of 48,700, an increase of 3,741 (8.3%) over 2020, and the largest single-year bump in recorded history. In turn, a record-high 42,508 applicants submitted program preferences, an increase of 2,424 (6.0%) over 2020 and the largest since 2013 when the All In Policy was implemented.

Growth in registration was seen in every applicant group, yielding more PGY-1 matches. Accordingly, concerns about the impact of virtual recruitment on applicants’ matching into PGY-1 positions were not realized:

  • The number of U.S. MD seniors who submitted rank ordered lists of programs was a record-high 19,866, an increase of 540 (2.8%) over 2020; 18,435 of them matched to first-year positions, an increase of 327 (1.8%) over 2020 and the highest number ever.
  • The number of U.S. DO seniors who submitted rank ordered lists of programs was a record-high 7,101, an increase of 520 (7.9%) over 2020; 6,327 of them matched to first-year positions, an increase of 359 (6.0%) over 2020 and the highest number ever.
  • The number of U.S. citizen international medical graduates (IMGs) who submitted rank ordered lists of programs was 5,295, an increase of 128 (2.5%) over 2020 and the highest in six years; 3,152 of them matched to first-year positions, a decline of two PGY-1 matched applicants over last year.
  • The number of non-U.S. citizen IMGs who submitted rank ordered lists of programs grew by 1,036 to 7,943, a 15.0 percent increase over 2020; 4,356 of them matched to first-year positions, an increase of 134 (3.2%) and the highest number ever.

Percent of Applicants Matched to PGY-1 Positions Declines Slightly for Seniors; Rates Remain High. With all applicant groups demonstrating increases in the number of applicants submitting rank ordered lists of programs and ultimately matching to first-year PGY-1 positions, the overall percent matched declined modestly for some groups. Specifically, the percent of U.S. MD seniors matched to PGY-1 positions declined from 93.7 to 92.8, and the percent of U.S. DO seniors matched to PGY-1 positions declined from 90.7 to 89.1 percent. Non-U.S. citizen IMGs saw the largest decline, from 61.1 percent in 2020 to 54.8 percent in 2021. The unavailability of medical licensure examinations in the early stages of the pandemic coupled with permanent changes to the scoring and administration of those examinations by the end of 2020 created significant challenges for IMGs this year and likely contributed to the decline. Additionally, changes in clinical rotations may have affected match rates. The overall percent of applicants matched to PGY-1 positions declined from 80.8 to 78.5 percent.

There were gains. The percent of U.S. MD graduates matched to PGY-1 positions increased from 45.6 percent to 48.2 percent in 2021. The percent of U.S. DO graduates matched to PGY-1 positions also increased, from 43.1 percent to 44.3 percent.

Applicants who did not match to a residency position participated in the NRMP Match Week Supplemental Offer and Acceptance Program® (SOAP®) to obtain an unfilled position. This year, 1,892 positions were offered during SOAP. SOAP results will be available in the full Match report published in early May.

Specialty Highlights

Strength of Specialties Visible in Senior Match Rates. The results of the Match can indicate the strength or competitiveness of specialties, as measured by the percentage of positions filled overall and the percentage filled by senior students in U.S. medical schools.

  • PGY-1 specialties with 30 positions or more that filled all available positions were Dermatology, Medicine-Emergency Medicine, Medicine-Pediatrics, Neurological Surgery, Otolaryngology Integrated Plastic Surgery, and Vascular Surgery.
  • PGY-1 specialties with 30 positions or more that filled more than 90 percent with U.S. seniors were Dermatology (100%), Medicine – Emergency Medicine (93.6%), Medicine – Pediatrics (93.5%), Otolaryngology (93.2%), Orthopedic Surgery (92.8%), and Integrated Plastic Surgery (90.4%).
  • PGY-1 specialties with 30 positions or more that filled less than 50 percent with U.S. seniors were Pathology (41.4 %) and Surgery – Preliminary (28%).

Primary care remains strong. Of the 35,194 first-year positions offered in the 2021 Main Match, 17,649 (49.6%) were in Family Medicine, Internal Medicine, Internal Medicine – Pediatrics, Internal Medicine – Primary, Pediatrics, and Pediatrics – Primary, an increase of 514 positions (3.0%) over the number offered in 2020. Of those offered in 2021,16,860 (95.5%) were filled and 11,013 (65.3%) were filled by U.S. seniors. Although the percent of primary care positions filled by U.S. seniors in 2021 represents a slight (0.3%) decline from the prior year, Family Medicine saw a gain of 63 U.S. MD seniors matched, and Internal Medicine saw a gain of 93 U.S. DO seniors matched in 2021.

Specialties as Indicators of Workforce Supply. Match results may also be a predictor of future physician workforce supply, especially when examining growth in specialties over time. In the last five years, the Main Residency Match has seen sizeable increases in the number of positions offered in Neurology (223 positions; 45.3% increase); Family Medicine (1,467 positions; 43.7% increase); Emergency Medicine (793 positions; 38,7% increase); Medicine – Primary (100 positions; 29.3% increase); Psychiatry (412 positions; 27.6% increase); and Internal Medicine (1,791 positions; 24.8% increase). Fills rates for these specialties has exceeded 92 percent for all five years.

View the Advance Data Tables, Match by the Numbers, and Match infographic for additional data and information.

The Match Process

For applicants, the Main Residency Match process begins in the fall during the final year of medical school, when they apply to the residency programs of their choice. Throughout the fall and early winter, applicants interview with programs. From mid-January to early March, applicants and program directors rank each other in order of preference and submit the preference lists to NRMP, which processes them using a computerized mathematical algorithm to match applicants with programs. Research using the NRMP algorithm was a basis for awarding The Sveriges Riksbank Prize in Economic Sciences in Memory of Alfred Nobel in 2012.

About NRMP

The National Resident Matching Program® (NRMP®) is a private, non-profit organization established in 1952 at the request of medical students to provide an orderly and fair mechanism for matching the preferences of applicants for U.S. residency positions with the preferences of residency program directors. In addition to the annual Main Residency Match® for more than 48,000 registrants, the NRMP conducts Fellowship Matches for more than 60 subspecialties through its Specialties Matching Service® (SMS®).