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Primary care slots outpace resident interest

Article

Internal medicine and family medicine have some of the largest numbers of positions still open after the matchmaking process despite record number of matches.

While the matchmaking process coordinated by the National Resident Matching Program saw 42,952 applicants and 40,375 certified positions, primary care fields still have triple-digit numbers of unfilled positions. Family medicine finished the matchmaking process with 577 unfilled positions, while internal medicine had 380.

Overall, both specialties filled more slots than any others, with family medicine filling 4,511 (89% of open slots) and internal medicine filling 9,345 (96%). For comparison, obstetrics had a 99.7% match rate and pediatrics had a 97% match rate. Emergency medicine had one of the lowest overall match rates, with 81.5% of slots being filled. Emergency medicine had 554 positions remain unfilled, an increase of 335 more unfilled positions than last year. The number of unfilled positions, driven in part by the decreased number of U.S. MD and U.S. DO seniors who submitted ranks for the specialty, could reflect changing applicant interests or projections about workforce opportunities post residency, according to the NRMP.

Internal medicine’s numbers were boosted by 2,659 foreign medical graduates being matched, accounting for 28.5% of all filled slots in the specialty, while family medicine only had 562 foreign graduates (12.5%). NRMP said the rise in applicants overall was driven primarily by the increase of 707 more non-U.S. citizen applicants.

Despite the number of unfilled slots, NRMP points out that there were a record number of slots for primary care and match rates are about the same as prior years – 94%.

“The 2023 Main Residency Match proved once again to be a highly successful match with outstanding results for participants,” said NRMP president and CEO Donna L. Lamb, DHSc, MBA, BSN, in a statement. “We were excited to see the record number of primary care positions offered in this year’s match and how the number of positions has consistently increased over the past five years, and most importantly, the fill rate for primary care has remained steady.”

Of the total number of applicants, 34,822 of those matched to a first-year position at a rate of 81.1%, an increase of 1% over last year.

According to NRMP, the 2023 Main Residency Match had the largest number of certified positions in history with 40,375, an increase of 1,170 positions and 3 percentage points more than the 2022 rate and an increase of 14.8% over the last five years. Of all positions offered, 37,690 filled for a rate of 93.3%, which is less than a one percentage point decline from 2022. Of the 37,425 PGY-1 positions offered, which includes preliminary and transitional year positions (one year of training), 34,822 filled for a rate of 93%. The fill rate for categorical positions (positions that provide the full training required for specialty board certification) was 97.5%. There were 6,270 total certified programs, which was an increase of 183 programs from 2022. Out of the total certified programs, 5,431 filled at a rate of 86.6%, a decrease of 1.6 percentage points over last year.

Specialties with 30 positions or more that filled all available positions in this year’s match were orthopedic surgery, plastic surgery (Integrated), radiology – diagnostic, and thoracic surgery.

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