Why Didn't I Make the Cut?

Why Didn't I Make the Cut?

As we enter into Graduate Medical Education (GME) interview season, many medical school graduates anxiously await interview offers from residency programs across the country. In recent years the acceptance into these GME programs has become increasingly more competitive. Since 2013, the number of U.S Seniors who did not match increased by 11%. However, an analysis of last year’s according to NRMP, in 2014 there were 1.54 PGY-1 positions for every active U.S senior.

So why are post-graduates still not matching? 

There are a few different reasons why graduates of U.S medical schools are having more difficulty matching in recent years.

  • Specialty choice: Specialty choice can definitely affect one’s ability to match. In 2014, 1,836 people applied to the 1,049 anesthesiology PGY-1 positions. This is particularly common in lucrative specialties such as obstetrics/gynecology, dermatology, and orthopedic surgery. However, in the past few years there has also been a slight increase of physicians applying to family medicine programs. This is great news considering the shortage of Primary Care Providers (PCP) we currently have in the United States. To learn more about this please read the previous blog “The Primary Problem.”
  • International and Foreign Medical Graduates: Medical school graduates and physicians across the world seek residency opportunities in the U.S. Additionally, more and more medical schools are opening up in the Caribbean. For this reason, we have seen a slight increase in the number of Foreign Medical Graduates1 (FMGs) and International Medical Graduates2 (IMGs) applying and matching to residency programs using the NRMP Match. In 2014 2,722 IMGs and 3,633 FMGs matched to residency programs across the United States. Together IMGs and FMGs now make up almost 25 percent of those matched to residency programs.

Even though there are more than enough residency positions for each U.S medical school graduate, specialty choice and the increasing number of IMG and FMG applicants make matching to residency programs much more competitive. The graph below illustrates how the total number of applicants registered for The Match has increased drastically over time, however, the number of residency positions available has not kept up.

NMRP Graph

1 Foreign Medical Graduates (FMGs) are non-U.S citizens who attended medical school outside of the U.S. 

2 International Medical Graduates (IMGs) are U.S citizens who attended medical school outside the U.S 

Sources: "Results and Data: 2014 Main Residency Match." National Resident Matching Program. 1 Jan. 2014. Web. 9 Oct. 2014. 

Salsberg,Edward. "The 2014 GME Residency Match Results: Is There Really A." Health Affairs Blog The 2014 GME Residency Match Results Is There Really A GME Squeeze Comments. 24 Apr. 2014. Web. 9 Oct. 2014.