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Results and Data2021 Main Residency Match May 2021www.nrmp.org
Requests for permission to use these data, as well as questions about the content of this publication or any NationalResident Matching Program data, may be directed to NRMP at datarequest@nrmp.org.Questions about the NRMP should be directed to Donna L. Lamb, D.HSc., M.B.A., B.S.N., President and CEOat admin@nrmp.org.Suggested CitationNational Resident Matching Program, Results and Data: 2021 Main Residency Match . National ResidentMatching Program, Washington, DC. 2021.To order copies of this publication, please contact:National Resident Matching Program2121 K Street, NW, Suite 1000, Washington, DC 20037Phone: 202-400-2233, Fax: 202-354-4586Price(Shipping not included) 50.00 - RDMAIN2021Copyright 2021 National Resident Matching Program, 2121 K Street, NW, Suite 1000, Washington, DC 20037USA. All rights reserved. Permission to use, copy and/or distribute any documentation and/or related images fromthis publication shall be expressly obtained from the NRMP.
NRMP Board of DirectorsNATIONAL RESIDENT MATCHING PROGRAM2121 K Street, NWSuite 1000Washington, DC 20037Composition of the 19-member Board of Directors includes: Chair, Chair-Designate, Secretary/Treasurer, and Immediate Past Chair One Designated Institutional Official One Osteopathic Physician Two graduate medical education program directors Three medical students, one of whom is enrolled in a US DO medical school Three resident physicians, one who is a US DO graduate and one who is an international medical graduate One public memberOfficers Chair: Steven J. Scheinman, M.D., President and Dean of the Geisinger Commonwealth Medical College Chair Designate: Donna D. Elliott, M.D., Ed.D., Vice Dean for Medical Education, University of SouthernCalifornia Keck School of Medicine Secretary/Treasurer: Deborah S. Clements, M.D., Chair, Family and Community Medicine, NorthwesternUniversity Feinberg School of Medicine Immediate Past Chair: Susan Guralnick, M.D., Associate Dean of Graduate Medical Education, University ofCalifornia, Davis President and Chief Executive Officer: Donna L. Lamb, DHSc., MBA., BSN., National Resident MatchingProgramBoard Members, 2020-2021 Keith B. Armitage, M.D., Vice Chair for Education, Department of Medicine, University Hospital CaseMedical Center Ricardo J. Bello, M.D., Resident Physician, UMass Memorial Medical Center, Worcester, MA Carol Berkowitz, M.D., F.A.A.P., F.A.C.E.P., Executive Vice Chair, Department of Pediatrics, Harbor-UCLAMedical Center E. Sander Connolly, Jr., M.D., Vice Chair, Department of Neurological Surgery, Columbia University Collegeof Physicians and Surgeons Holly J. Humphrey, M.D., M.A.C.P., President, The Josiah Macy Jr. Foundation Michael G. Kavan, Ph.D., Associate Dean for Student Affairs, Creighton University School of Medicine Cathy Lazarus, M.D., Associate Dean for Student Affairs and Records, LSU Health Sciences Center, NewOrleans Heather A. Lillemoe, M.D., Resident Physician, Vanderbilt University Ebony White-Manigault, M.P.H., M.D. Candidate, Wayne State University School of Medicine Sydney N. Miller, D.O. Candidate, Michigan State University College of Osteopathic Medicine Alvin E. Roth, Ph.D., Professor of Economics, Stanford University Edward S. Salsberg, M.P.A., Director of Health Workforce Studies, Health Workforce Institute, GeorgeWashington University Kenneth B. Simons, M.D., Senior Associate Dean for GME and Accreditation, Professor of Ophthalmology andPathology, Medical College of Wisconsin Morgan B. Swanson, M.D./Ph.D. Candidate, University of Iowa Carver College of Medicine Christopher Traner, M.D., Clinical Fellow, Yale-New Haven Hospital, New Haven, CT Donna L. Lamb, DHSc, MBA, BSN, ex-officio memberResults and Data 2021 Main Residency Match i
Table of ContentsNRMP Board of Directors . iAbout the NRMP . ivFigure 1. Applicants and 1st Year Positions in The Match, 1952-2021 . ivDefinitions. vIntroduction . viTable 1A. Match Summary for MD Seniors, 2021 . 1Table 1B. Match Summary for DO Seniors, 2021 . 4Table 2. Matches by Specialty and Applicant Type, 2021 . 6Table 3. Positions Offered in the Matching Program, 2017-2021 . 9Table 4. Applicants in the Matching Program, 2017-2021 . 12Figure 2. Number of Active Applicants and Percent Matched to PGY-1 Positions, 2017-2021 . 13Figure 3. Positions per All Active and Active U.S. Senior Applicant, 1976-2021 . 15Table 5. Number of PGY-1 Positions per Active Applicant, 1976-2021 . 15Figure 4. PGY-1 Match Rates by Applicant Type, 1990-2021 . 17Table 6. PGY-1 Match Rates, 1992-2021. 17Table 7A. Positions Offered and Number Filled by MD Seniors and All Applicants, 2017-2021 . 19Table 7B. Positions Offered and Number Filled by DO Seniors and All Applicants, 2017-2021 . 22Figure 5. Number of Positions Offered and Filled for Selected Specialties, 2021 . 24Table 8. Positions Offered and Percent Filled by MD Seniors and All Applicants, 2017-2021 . 25Table 9. All Applicants Matched to PGY-1 Positions by Specialty, 2017-2021 . 27Table 10. MD Seniors Matched to PGY-1 Positions by Specialty, 2017-2021 . 29Table 11. DO Seniors Matched to PGY-1 Positions by Specialty, 2017-2021 . 30Table 12. Foreign-Trained Physicians Matched to PGY-1 Positions by Specialty, 2017-2021 . 31Table 13A.U.S. MD Seniors and U.S. DO Seniors Choices by Specialty, 2021 . 32Table 13B.U.S. IMG and Non-U.S. IMG Choices by Specialty, 2021. 34Table 14A.Match Results for U.S. MD Seniors and U.S. DO Seniors Who Ranked Each Specialtyas Their Only Choice, 2021 . 35Table 14B.Match Results for U.S. IMG and Non-U.S. IMG Who Ranked Each Specialtyas Their Only Choice, 2021 . 36Figure 6. Percentages of Unmatched MD Seniors and DO Seniors Who Ranked Each Specialtyas Their Only Choice, 2021 . 37Table 15. Matches from MD Seniors' and Independent Applicants' Rank Order Lists, 1997-2021 . 38Figure 7. Percent of Matches by Choice and Type of Applicant, 2021 . 40Table 16. Number of Couples in the Match and Match Outcome, 1987-2021 . 41Figure 8. Number of Couples in the Match and Match Outcome, 1987-2021 . 42Results and Data 2021 Main Residency Match ii
Table of Contents (Continued)Table 17. Average Number of Ranked Applicants Needed to Fill Each Position by Specialty, 2017-2021 . 43Table 18. Participating Programs and Positions Filled in SOAP, 2020-2021. 46Table 19. SOAP Applicants Accepting Positions by Type, 2020-2021 . 47Figure 9. Offers Extended in SOAP, 2012-2021 . 47NRMP Program Results 2021 Main Residency Match. 48Results and Data 2021 Main Residency Match iii
About the NRMP(Figure 1), the nineteenth consecutive annual increase.The total number of positions, at 38,106, also was anall-time high.The National Resident Matching Program (NRMP ) is aprivate, not-for-profit corporation established in 1952 tooptimize the rank-ordered choices of applicants andprogram directors for clinical training in the United States.The NRMP is not an application processing service; rather,it provides an impartial venue for matching applicants' andprograms' preferences for each other using aninternationally recognized mathematical algorithm.The trend in the total number of applicants is moredramatic, rising from 6,000 in 1952 to 36,056 in 1999.After a decline of 5,052 applicants from 1999 to 2003,the number has risen each year since the 2004 Match. In2021, the number of registrants reached an all-time highof 48,700, an increase of 3,741 over 2020.The first Main Residency Match ("the Match") wasconducted in 1952 when 10,400 internship positions wereavailable for 6,000 graduating U.S. medical school seniors.By 1973, there were 19,000 positions for just over 10,000graduating U.S. seniors. Following the demise ofinternships in 1975, the number of first-year post-graduate(PGY-1) positions declined to 15,700; however, thenumber of PGY-1 positions gradually increased through1994 before declining slowly until 1998. Since that time,the number of PGY-1 positions has only increased. Thisyear, an all-time high 35,194 PGY-1 positions were offeredFigure 1For more information about the NRMP, please visit:www.nrmp.org. Additional data and reports for the MainResidency Match and the Specialties Matching Service (SMS ) are at: http://www.nrmp.org/main-residencymatch-data/ and http://www.nrmp.org/fellowship-matchdata/. Instructions on how to request NRMP data also areprovided.Applicants and 1st Year Positions in the Match, 1952 - 202160,00050,00040,000Total Applicants30,00020,000Total PGY-1 Positions10,000019521960197019801990Results and Data 2021 Main Residency Match 20102000iv2021
Definitions/OrganizationsACGMEAccreditation Council for Graduate Medical Education.Active ApplicantAn applicant who submits a certified rank order list of programs.All In PolicyAny program registering for the Match must attempt to fill all positions through the Match or another nationalmatching plan.Applicant TypeThe NRMP classifies applicants for the Main Residency Match into eight types: A 4th-year medical student in a U.S. allopathic medical school accredited by the Liaison Committee onMedical Education (LCME) with a graduation date after July 1 in the year before the Match; also referredto as a U.S. MD senior. A 4th-year medical student in a U.S. osteopathic medical school accredited by the Commission onOsteopathic College Accreditation (COCA) with a graduation date after July 1 in the year before theMatch; 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 ofmedicine 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 ofmedicine 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. Student/Graduate of Canadian Medical School (Canadian): A senior student or graduate of a Canadianschool of medicine accredited by the Committee on Accreditation of Canadian Medical Schools (CACMS). Graduate of Fifth Pathway Program (5th Pathway): A graduate of a U.S. Fifth Pathway program. U.S. Citizen Student/Graduate of International Medical School (U.S. IMG): A U.S. citizen who attendedan international medical school. Non-U.S. Citizen Student/Graduate of International Medical School (Non-U.S. IMG): A non-U.S. citizenwho attended an international medical school.In this report, applicant types are sometimes combined into a smaller number of groups. Foreign-Trained Physicians: U.S. citizen and non-U.S. citizen students and graduates of internationalmedical schools.Others: Includes previous graduates of MD and DO, Canadian and Fifth Pathway applicants.CoupleAny two applicants who register as a couple in the Match. The NRMP allows couples to form pairs of choiceson their primary rank order lists, which are considered in rank order when the matching algorithm is processed.Couples match to the most preferred pair of programs where each partner has been offered a position.PGY-1 & PGY-2Post-graduate year one and post-graduate year two.Program TypeThe NRMP classifies programs for the Main Residency Match into five types: Categorical (C) programs: Programs that begin in the PGY-1 year and provide the full training required forspecialty board certification. Primary (M) programs: Categorical programs in primary care medicine and primary care pediatrics thatbegin in the PGY-1 year and provide the full training required for specialty board certification. Preliminary (P) programs: One-year programs that begin in the PGY-1 year and provide prerequisitetraining for advanced programs. Advanced (A) programs: Programs that begin in the PGY-2 year after a year of prerequisite training. Physician (R) programs: Programs that are reserved for physicians who have had prior graduate medicaleducation. Reserved programs offer PGY-2 positions that begin in the year of the Match and thus are notavailable to senior medical students.SOAPThe Supplemental Offer and Acceptance Program (SOAP ) is a process by which eligible unmatchedapplicants in the Main Residency Match apply for and are offered positions that did not fill when the matchingalgorithm was processed.Results and Data 2021 Main Residency Match v
IntroductionThis report summarizes data from the National Resident MatchingProgram (NRMP) 2021 Main Residency Match, the largest in NRMPhistory when measured by the number of positions offered (38,106) andfilled (36,179). The 35,194 PGY-1 positions offered constituted an all-timehigh and an increase of 928 over 2020; more than half the increase wasattributable to growth in Family Medicine and Internal Medicine. Thenumbers of registrants (48,700) and active applicants (42,508) also wereall-time highs, with 3,741 more registrants and 2,424 more activeapplicants compared to 2020.CouplesCouples have been able to participate in the Match since 1984. In the 2021Match, 2,448 individuals participated as couples, the same as 2020. ThePGY-1 match rate was 93.4 percent in 2021.Other Notable TrendsMatch results can be an indicator of physician workforce trends. Highlightsin 2020 include:Position Fill Rate The ratio of PGY-1 positions per active U.S. MD senior was 1.77, thesame as last year, and the highest since 1976.A successful Match is measured not just by volume, but also by how well itmatches the preferences of applicants and program directors. Based on thatcriterion, the overall position fill rate for the 2021 Match was 94.9 percent.After the matching algorithm was processed, 1,927 of the 38,106 positionswere unfilled. There were an additional 66 positions that were unfilled inprograms that did not submit a rank order list, bringing the total unfilled to1,993. Of those, 1,892 were placed in the Match Week Supplemental Offerand Acceptance Program (SOAP). At the conclusion of SOAP, there wereonly 220 total positions remaining unfilled, for a post-SOAP fill rate of99.6 percent. Primary care specialties offered record-high numbers of positions andhad high position fill rates: In 2021, a total of 6,878 U.S. MD seniors and 3,441 U.S. DOseniors matched to categorical positions in Family Medicine,Internal Medicine, and Pediatrics. Though the numbers of positions for Internal Medicine(categorical) have fluctuated, 9,024 positions in 2021 is thehighest number on record and 8,632 filled (95.7%). U.S. MDseniors filled 39.0 percent, 1.2 percent less than last year; U.S.DO seniors filled 16.4 percent, an increase of 0.4 percent overlast year. In 2021, Family Medicine offered 4,823 positions (the highestnumber since 1992) and 4,472 filled (92.7%). U.S. MD seniorsfilled 33.3 percent of the positions; however, a record number ofU.S. DO seniors (1,440) matched, accounting for 29.9 percent oftotal applicants who matched to the specialty. Pediatrics (categorical) has gained positions every year since2005 and offered a record-high 2,901 positions in 2021. Theoverall fill rate was 98.6 percent, with 60.3 percent filled by U.S.MD seniors and 17.9 percent filled by U.S. DO seniors.Applicant TrendsThis year, 42,508 active applicants vied for the 35,194 first-year and 2,912second-year (including physician (R)) residency positions U.S. MD seniorstudents comprised 19,866 of the active applicants, 540 more than in 2020.The PGY-1 match rate for U.S. MD seniors was 92.8 percent. Historically,the PGY-1 match rate for U.S. MD seniors has been 92-95 percent.The number of U.S. DO senior students continues to grow. An all-timehigh of 7,101 U.S. DO seniors submitted rank order lists of programs, 520more than in 2020, and 6,327 of them matched to PGY-1 positions. ThePGY-1 match rate for U.S. DO seniors in 2021 was 89.1 percent.More U.S. citizen and non-U.S. citizen students and graduates ofinternational medical schools (IMGs) registered for the Match than in2020. Of the 5,295 U.S. IMGs who submitted rank order lists of programs,3,152 matched to a PGY-1 position for a match rate of 59.5 percent. Ofthe 7,943 non-U.S. citizen IMGs who submitted rank order lists ofprograms, 4,356 matched to a PGY-1 position for a match rate of 54.8percent. The number of Psychiatry positions has grown every year since 2008.There were 1,907 positions offered in 2021, an increase of 838positions (78.4%) in 14 years. In 2021, 14,115 applicants were eligible to participate in SOAP, 2,299more than in 2020. A fourth SOAP offer round was added in 2021. Ofthe 1,892 positions placed in SOAP, 1,773 positions filled, 86 morethan 2020.Other features of interest include: In 2021, the overall number of registered applicants was 48,700, thehighest in the history of the Match.We hope you find the data contained in the following pages useful as youreflect on the 2021 Match and prepare for future Matches. The number of registered non-U.S. citizen IMGs was 10,718, 1,762more than last year.Donna L. Lamb, D.HSc., M.B.A., B.S.N.,President and Chief Executive OfficerNational Resident Matching Program2121 K Street NW, Suite 1000Washington, DC 20037admin@nrmp.org The percentage of all U.S. MD seniors who matched to theirfirst-choice programs was 46.4 percent; however, 72.3% of U.S. MDseniors matched to one of their top three choices. The percentage of DO seniors who matched to their first-choiceprograms was 42.4 percent, however, 72.2% matched to one of theirtop three choices.Results and Data 2021 Main Residency Match vi
Table 1Table 1 summarizes the 2021 Main Residency Match and shows the numbers of participating programs, offeredpositions, and unfilled programs. It also provides ranking and matching data for U.S. MD seniors (Table 1A) and U.S.DO seniors (Table 1B).Using Anesthesiology PGY-1 as an example on Table 1A: The first three columns (“No. of Programs,” “Positions Offered,” and “Unfilled Programs”) show that 159programs offered 1,460 Anesthesiology PGY-1 positions and that 2 of those programs were unfilled after thematching algorithm had been processed. The numbers of U.S. MD senior applicants and total applicants are provided in the next two columns under“No. of Applicants.” In 2021, 1,460 U.S. MD seniors ranked at least one Anesthesiology program, and 2,706applicants in total ranked Anesthesiology. Note that the figures do not mean that Anesthesiology was thepreferred choice of those applicants. The next two columns (under “No. of Matches”) show that 1,024 of the 1,460 PGY-1 positions offered inAnesthesiology were filled by U.S. MD seniors, with 1,457 filled by all applicants. The fill rates (calculated as positions filled divided by positions offered) can be found in the two columnsunder “% Filled.” Of the 1,460 PGY-1 positions offered in Anesthesiology, 70.1 percent were filled by U.S.MD seniors and 99.8 percent were filled overall. The “Ranked Positions” columns show that, collectively, U.S. MD seniors ranked the positions offered bythose Anesthesiology programs 15,977 times and the total number of ranks by all applicants was 23,046.The 2021 Match offered 38,106 positions, 850 more than 2020; of those, 35,194 were PGY-1 positions, 928 more thanlast year.Results and Data 2021 Main Residency Match 1
Table 1AMatch Summary for MD Seniors, 2021SpecialtyNo. ofApplicants*MDNo. of Positions UnfilledPrograms Offered Programs Seniors TotalNo. ofMatches*MDSeniors Total%FilledMDSeniors TotalRankedPositionsMDSeniors TotalPGY- 1 PositionsAnesthesiologyChild ermatologyEmergency 041753425Family MedicineFamily Med-Preventive Med72924,823213001,83777,496131,6061Internal Medicine mergency Med51283110276532122719Medicine-Medical rventional Radiology (Integrated)Neurodevelopmental Disabilities234416301621022122303Neurological Obstetrics-GynecologyOB/GYN-Preliminary (PGY-1 c SurgeryOsteo Neuromusculoskeletal gy129165350611014454212559945310198Pediatrics 01,969143,976191,7498Pediatrics-Emergency MedPediatrics-Medical Genetics4208270225234044719Pediatrics-P M & ics-PrimaryPeds/Psych/Child Psych14975211036846790623919Physical Medicine & RehabPlastic Surgery yPsychiatry-Family ry-NeurologyRadiation ery 9Surgery-Preliminary (PGY-1 Only)Thoracic 6518,435Emergency Med-AnesthesiologyEmergency Med-Family MedMedicine-Preliminary (PGY-1 Only)Medicine-Preventive MedTransitional (PGY-1 Only)Vascular SurgeryTotal PGY- 1Results and Data 2021 Main Residency Match 95827,7671,616329,35938,8261,994530,238
Table 1AMatch Summary for MD Seniors, 2021 (Continued)SpecialtyNo. ofApplicants*MDNo. of Positions UnfilledPrograms Offered Programs Seniors TotalNo. ofMatches*MDSeniors Total%FilledMDSeniors TotalRankedPositionsMDSeniors TotalPGY- 2 PositionsAnesthesiologyChild 095883,6101,657226,45267011,791AnesthesiologyChild nal Radiology (Integrated)142202000075200Neurodevelopmental ,41171,077DermatologyInterventional Radiology (Integrated)Neurodevelopmental DisabilitiesNeurologyNuclear MedicineOsteo Neuromusculoskeletal MedPhysical Medicine & RehabRadiation OncologyRadiology-DiagnosticRadiology-Nuclear MedTotal PGY- 00312300569Physician (R) Positions**Osteo Neuromusculoskeletal MedPhysical Medicine & RehabRadiation OncologyRadiology-DiagnosticRadiology-Nuclear MedTotal Physician (R)GRAND 0,026575,318* Applicants can rank multiple specialties. In 2021, 2,347 applicants matched to both PGY-1 and PGY-2 positions; of those applicants, 1,743 were U.S.MD seniors.** Physician (R) positions are PGY-2 positions starting in the year of the Match that are reserved for applicants who have had prior graduate medicaleducation. Physician positions are not available to senior medical students. In previous Results and Data Books, the numbers of R positions were smalland they were included in the categorical position counts. In 2014, NRMP began listing R positions separately.Results and Data 2021 Main Residency Match 3
Table 1BMatch Summary for DO Seniors, 2021SpecialtyNo. ofApplicants*No. of Positions UnfilledDOPrograms Offered Programs Seniors TotalNo. ofMatches*DOSeniors Total%FilledDOSeniors TotalRankedPositionsDOSeniors TotalPGY- 1 .499.83,90623,046Child 902005099.5100.041,202127.80.011,211Emergency Med-Anesthesiology2,826205Emergency Med-Family 311,994530,238Emergency MedicineFamily MedicineFamily Med-Preventive MedInternal Medicine 320123104012210Medicine-Emergency MedMedicine-Medical GeneticsMedicine-PediatricsMedicine-Preliminary (PGY-1 Only)Medicine-Preventive try1224010941Interventional Radiology velopmental DisabilitiesNeurological ology2791,46023362,030225OB/GYN-Preliminary (PGY-1 Only)Orthopedic SurgeryOsteo Neuromusculoskeletal ics hesiology5803190Pediatrics-Emergency Med4809401Pediatrics-Medical atrics-P M & 9157122358949Peds/Psych/Child PsychPhysical Medicine & RehabPlastic Surgery atry-Family on 22118698928Surgery ry (PGY-1 Only)2491,1361452181,989473546161291Thoracic SurgeryTransitional (PGY-1 Only)Vascular SurgeryTotal PGY- 10,69318163,99336,3277933,353Results and Data 2021 Main Residency Match 451034355,64224315667131,5449,8403,01620,
About the NRMP Total Applicants Total PGY-1 Positions 0 10,000 20,000 30,000 40,000 50,000 60,000 1 952 196 0 1 7 1980 1990 200 201 2021 Figure 1 Applicants and 1st Year Positions in the Match, 1952 - 2021 The National Resident Matching Program (NRMP ) is a private, not-for-profit corporation established in 1952 to
