Charting Outcomes™: Demographic Characteristics of Applicants in the Main Residency Match® and SOAP®

NRMP is pleased to report findings of the demographic data collection from applicants to the 2022 and 2023 Main Residency Match.

Want to learn how to get the most out of the Charting Outcomes™: Demographic Characteristics of Applicants in the Main Residency Match® and SOAP® report? This video tutorial provides an overview of how the interactive report works, its features, and how to best utilize the report.

Background

Increasing evidence demonstrates that patients treated by providers with demographic characteristics similar to their own are more satisfied, adhere better to treatment, and show better clinical outcomes.  In addition, physicians who belong to groups underrepresented in medicine are more likely to care for underserved populations. 

Despite these facts, striking demographic differences between physicians and the patient populations they serve are well documented.  It is essential to understand the roles of applicant demographics and potentially related biases throughout the UME-GME transition, from application submission and review through interviewing and ranking.  In response to this need, the NRMP has implemented collection and analysis of demographic data from applicants. 

Purpose:

The aim of applicant demographic data collection and analysis is to advance understanding of and encourage discussion about relationships among the unique characteristics of applicants, the specialties they pursue, and their experience in the Match.  The NRMP is making findings from this work available to the community in order to help inform efforts to increase the transparency and understanding of the matching process, improve diversity, equity, inclusion, and belonging (DEI-B) in the transition to residency, and address the implications of DEI-B issues and actions to resolve them for both the physician work force and the health of patient populations to be served.

Charting Outcomes™: Demographic Characteristics of Applicants in the Main Residency Match and SOAP has been built using data visualization software and draws from the demographic questions asked of applicants registering for the Main Residency Match in the NRMP’s Registration, Ranking, and Results® (R3®) system. These questions cover characteristics including:

  • Sex assigned at birth
  • Sexual orientation
  • Gender identity
  • Race identities
  • Hispanic/Latinx/Spanish ethnicity
  • Disability status and accommodations sought during medical school
  • Urbanicity of childhood rearing environment
  • First-generation college and medical school graduation statuses
  • Family socioeconomic factors during applicants’ childhoods 

Version History

Version
Number
Date
Published
Description of changes since previous version
1.1May 1, 2023N/A
1.2May 30, 2023Applicants who preferred or matched to a preliminary/transitional program are included in version 1.2 of this report. The following changes have been made:
– Data visualizations now include applicants who preferred or matched to a preliminary/transitional program.
– Data visualizations now include a “Program Type” dropdown menu.
– The “Sample and Consent Rates for the Present Report” section has been updated to include applicants who preferred or matched to a preliminary/transitional program (this includes the narrative and associated tables).
1.3June 29, 2023Additional information regarding applicants who were eligible for and/or participated in SOAP has been included in version 1.3 of this report. To capture all SOAP eligible applicants, the data included in some visualizations have been expanded to include all applicants who registered to participate in the Main Residency Match and are not restricted to only active applicants. The following visualizations have been added:

– Demographic characteristics of all registered applicants
– Demographic characteristics of all active applicants who were matched by the algorithm by their matched specialty
– Demographic characteristics of all applicants who accepted an offer during SOAP by the specialty in which they accepted an offer
– Demographic characteristics of applicants who participated in the Match but were not matched by the algorithm
– Demographic characteristics of applicants who were eligible to participate in SOAP but did not accept a position during this process

A Table of Contents screen was also added to streamline navigation throughout the report.
 

How to Interpret the Data

Charting Outcomes™: Demographic Characteristics of Applicants in the Main Residency Match and SOAP consists of two sections:  

  • Narrative text that describes the background and methods of the NRMP’s demographic data collection; and
  • A series of visualizations of the demographic composition of each specialty and, within specialty, Main Residency Match and SOAP outcomes.  The number and granularity of the visualizations depend on the sample sizes for each of the data cells of interest (see below, Data Considerations).

Drop-down menus at the top-center of the dashboard allow users to select the data they would like to view. Across the visualizations there are eight drop-down menus to utilize:  

  • Match Year: Viewers can choose to view an individual year of data, or they can view cumulative data by selecting multiple years (or selecting “All”).  
  • Preferred/Matched/Accepted Combined Specialty Group: In order to include as many of the smaller specialties as possible in this report, some were rolled up into superordinate categories (e.g., all Internal Medicine-related specialties were rolled up under “Internal Medicine & All Combined Specialties” in this dropdown). When viewers select one of these superordinate categories, they can then select a specific specialty from the Preferred Specialty drop-down. 
  • Preferred/Matched/Accepted Specialty: This menu complements the Preferred/Matched/Accepted Combined Specialty Group menu and allows the viewer to drill down into specific specialties within a superordinate category. For example, if the viewer only wants to view Internal Medicine and not the associated specialties, they would select “Internal Medicine & All Combined Specialties” from the previous drop-down, then “Internal Medicine” under the Preferred/Matched/Accepted Specialty drop-down.  

NOTE: Once a viewer selects from the Preferred/Matched/Accepted Specialty menu, the viewer must set this menu back to “All” to reset the Preferred/Matched/Accepted Combined Specialty Group menu to the full list of specialty options.  

  • Applicant Type: Viewers can choose which applicant types they are interested in viewing. Options include U.S. MD senior, U.S. DO senior, U.S. MD graduate, U.S. DO graduate, U.S. IMG, non-U.S. IMG. See the Definitions section below for details on each applicant type. 
  • Program Type: Viewers can choose which of the five program types they are interested in viewing. Options include Categorical (C), Primary (M), Preliminary/Transitional (P), Advanced (A), and Reserved (R; also known as “Physician Positions”). See the Definitions section below for details on each program type.

DEFINITIONS

Accepted Specialty

The specialty in which an applicant accepts a position during SOAP.

Active Applicant 

An applicant who submits a certified rank order list of programs. 

Applicant Type1 

  • A 4th-year medical student in a U.S. allopathic medical school accredited by the Liaison Committee on Medical Education (LCME) with a graduation date after July 1 in the year before the Match; also referred to as a U.S. MD senior
  • A 4th-year medical student in a U.S. osteopathic medical school accredited by the Commission on Osteopathic College Accreditation (COCA) with a graduation date after July 1 in the year before the Match; also referred to as a U.S. DO senior
  • Previous Graduate of U.S. MD Medical School (U.S. MD Grad): A graduate of a U.S. allopathic school of medicine accredited by the LCME with a graduation date before July 1 in the year before the Match. Previous U.S. graduates are not sponsored by their medical schools. 
  • Previous Graduate of U.S. DO Medical School (U.S. DO Grad): A graduate of a U.S. osteopathic school of medicine accredited by the COCA with a graduation date before July 1 in the year before the Match. Previous U.S. DO graduates are not sponsored by their medical schools. 
  • U.S. Citizen Student/Graduate of International Medical School (U.S. IMG): A U.S. citizen who attended an international medical school. 
  • Non-U.S. Citizen Student/Graduate of International Medical School (Non-U.S. IMG): A non-U.S. citizen who attended an international medical school. 

1 While the NRMP defines eight types of applicants, Canadian and Fifth Pathway applicants were excluded from this report due to small cell sizes. 

Matched Specialty

The specialty of the program to which an applicant matches through the matching algorithm.

Preferred Specialty 

The specialty of the program ranked first on the rank order list.

Program Type

  • Categorical (C): Post graduate year one (PGY-1) position that provides the full training required for board certification in a specialty.
  • Primary (M): Categorical position in Medicine or Pediatrics that provide a training emphasis on primary care.
  • Preliminary/Transitional (P): One-year position in a Transitional Year or specialty program.
  • Advanced (A): PGY-2 positions in a specialty program that begins the year after the Match and after one or more years of required preliminary training
  • Reserved (R): PGY-2 positions in specialty programs that begin in the year of the Match and are reserved for physicians with prior graduate medical education. These positions are also known as “Physician Positions”.

Obtained a Position versus Did Not Obtain a Position 

Whether or not the applicant obtained a position either through matching during the Main Residency Match or by accepting an offer during the SOAP process. 

Registered Applicant

An applicant who has registered to participate in the Main Residency Match in the NRMP’s Registration, Ranking, and Results (R3) system.

SOAP 

The Supplemental Offer and Acceptance Program (SOAP) is a process by which eligible unmatched or partially matched applicants in the Main Residency Match apply for and are offered positions that did not fill when the matching algorithm was processed.

SOAP Eligible Applicant

An applicant who has registered in R3 for the Main Residency Match, is unmatched or partially matched on Monday of Match Week, and is eligible to enter graduate medical education on July 1st of the Match Year (verified by an applicant’s medical school or ECFMG for IMGs).

Data Considerations:

  • A minimum cell size of 25 respondents was required for all data points included in the report. In some cases, the threshold affected which demographic characteristics could be reported (e.g., current gender identity, specific disability types, and disability accommodations sought during medical school could not be reported from the 2022 or 2023 data).   
  • The minimum cell size requirement also restricted which response options within a characteristic could be reported (for example, race could be reported for a specialty in Match Year 2022 but only for specific race types like Black/African American, Asian, and White).
  • In future years, as sample sizes accrue, the NRMP will report more results, including more variables, more response options, and higher granularity with more subgroup-specific (e.g., by applicant type) findings.
  • Not all applicants consented to provide demographic data for research and not all those who consented to provide the data answered all questions; accordingly, missing data exist in all characteristics.