Despite a record number of applicants and slots filled for first-year residents on the 2017 Match Day, growth in all surgery positions continued to be outpaced by growth in other specialties.
“While it is encouraging to see that the number of categorical surgery positions offered has increased by 101 since 2013, representing an increase of 8.6%, over the same period, the number of positions offered in emergency medicine and family medicine positions have each increased by over 300, representing increases of 17.4% and 11.5%, respectively, and the number of internal medicine positions has increased by over 900, representing an increase of 15.2%,” Patrick Bailey, MD, FACS, medical director of advocacy for the Division of Advocacy and Health Policy at the American College of Surgeons. “The fact that over 35,969 applicants submitted program choices and only 27,688 matched into a PGY-1 position is yet another indication of the need to expand the number of graduate medical education positions available,” he added.
Dr. Patrick V. Bailey
And while more positions may be needed, the number of categorical surgery positions that went unfilled remained low, with only 5 of 1,281 slots remaining unfilled at the conclusion of Match Day 2017, according to the data released by the National Resident Match Program (NRMP).
“This result is consistent with those since 2013 during which time the number of unfilled positions has varied between two and seven positions, e.g., 99.4%-99.8% of categorical surgery positions offered were filled,” Dr. Bailey said.
Still, the ACS is advocating for further changes to the resident matching program to help build the future workforce. “The ACS believes broad reforms in the way graduate medical education is funded and administered are necessary and overdue to ensure that our nation is able to produce the physician workforce capable of meeting the needs of the U.S. population,” he said. To that end, the ACS produced a policy paper that outlined a series of steps relative to reform for which it is advocating.
Broadly, those reforms include the collection of actionable and accurate health care workforce data, maintenance of current GME funding levels with the appropriation of temporary additional funds to modernize the system, the combination of the current GME funding streams into a single stream of funds, and the consideration of a regionalized governance system.
Overall, this is the fifth straight year the NRMP has reported growth in applicants, up 1.4% from the previous year, and applicants matched, to PGY-1 positions up 3.2% from 2016.
One factor driving the increase is the “all-in” policy that required programs registering for the Match to offer all their available positions in the Match or another national matching program. The policy, which began with the 2013 Match, has resulted in significant increases for internal medicine, family medicine, and pediatrics.
Internal medicine residency programs offered 7,233 programs, accounting for about 25% of all PGY-1 positions. This was up from 7,024 programs offered last year. U.S. seniors accounted for 44.9% of the 7,101 slots filled, a rate that was slightly lower than the 46.9% of slots filled by U.S. medical school graduates in 2016.
A record-high 18,539 allopathic medical school seniors submitted program choices and 17,480 (94.3%) were matched to first-year resident programs, a rate that has been consistent for a number of years according to NRMP data.
Of the 1,279 unfilled slots, 1,177 were offered in the Match Week Supplemental Offer and Acceptance Program, the results of which will be available in May.
One trend that stood out for NRMP President and CEO Mona Signer was the decline in both U.S.- and non–U.S.-citizen international medical school graduates (IMGs) who submitted program choices.
“I was surprised that the number of U.S.-citizen and non–U.S.-citizen IMGs declined this year, but on the other hand, the good news is their match rates went up,” Ms. Signer said in an interview.
U.S.-citizen IMGs declined by 254 to 5,069, but 54.8% were matched to first-year residency positions, the highest match rate since 2004. The number of non–U.S.-citizen IMGs declined by 176 to 7,284, but 52.4% were matched to first-year positions, the highest match rate since 2005.
Ms. Signer declined to speculate what caused the decline, noting that NRMP does not collect demographic data.