2024 Match Day highlights applicant, residency position growth

Medical students filled a record number of residency positions this year as some states and individual health systems funded an increased number of graduate medical education slots amid federal caps.

Hospitals and medical centers offered 41,503 residency positions in 2024, a 3% increase from last year, according to Match Day results released Friday by the National Resident Matching Program. Still, teaching hospitals and doctors' advocates have said there aren't enough positions or students to cope with growing physician workforce shortages.

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About 44,850 people applied for residencies this year, the highest number of applicants in the history of the 72-year-old match program. The increase was driven by U.S. osteopathic medicine doctorate candidates and non-U.S. citizen international medical school graduates.

Applicants filled 93.8% of slots — 38,941 positions —  during the residency match, a similar percentage to last year. Internal and emergency medicine, thoracic surgery, integrated interventional radiology and obstetrics-gynecology filled the highest percentage of residency slots.

Emergency medicine saw a significant improvement. Last year about 550 slots were still open after the initial match. This year, the specialty had 3,026 positions and filled 2,891, leaving 135 unfilled.

Specialties like family medicine and pediatrics had a harder time. Family medicine had 636 unfilled positions, around 60 more than last year. Pediatrics, which added about 100 slots in 2024, had 252 unfilled positions and filled 91.8% of its slots. That's a drop from 2023, when pediatrics filled 97% of its slots.

Across specialties, 2,575 unfilled positions were placed in the Supplemental Offer and Acceptance Program, and medical students who didn't initially match to a residency position will have another chance. Most positions in the program are eventually filled.

The overall number of residency positions has increased by 75% over the past two decades, according to the NRMP. The number of medical school students has grown by 37%, driven primarily by communities' rising demand for physicians, said Dr. Jesse Ehrenfeld, president of the American Medical Association.

Medical schools and hospitals have pushed to increase the number of Medicare-funded graduate medical education slots. But caps on federal backing remain, so some states and health systems have taken it on themselves to create and finance residency positions, often in high-need areas.

At Houston Methodist, only half of the system’s nearly 400 residency positions are supported by Centers for Medicare and Medicaid Services funding, said Dr. Lara Colton, designated institutional official of graduate medical education programs at the Houston-based health system. The other half are backed by internal funds and philanthropy.

Many of Houston Methodist’s residency slots are funded by the Texas Higher Education Coordinating Board, which has also given the health system additional resources to create more family medicine and OB-GYN residency programs, Colton said.

Having more graduate medical education slots available statewide will hopefully encourage more medical students in Texas to stay for their residencies and practice in the state, she said.

This year, Houston Methodist had 75 residency positions available. All were filled.

Duke University Hospital and Health System, which boasts almost 1,200 residents and fellows, funds the majority of its physician trainees, said Dr. Catherine Kuhn, director of Graduate Medical Education at the Durham, North Carolina-based health system.

“While we likely do not need more total positions, we would like more funding of the slots we have,” Kuhn said. “We might consider redistribution of positions at some point in the future.”

As more students and graduates enter the residency matching system each year, the industry needs to ensure an adequate amount of clinical rotation opportunities and residency positions exist, said Donna Lamb, president and CEO of the National Resident Matching Program.

She said health system leaders may also need to reconsider their distribution of graduate medical education slots, both by specialty and geography.