I’ve written about residency “match day” on a few past occasions. That’s the big day in March when soon-to-graduate medical students learn where the next phase of their education will take them. It’s the day when students learn if the specialty, the institution, and the residency program they liked also likes them enough to select them for the program.
For at least two-thirds of graduates, this process works to completion, and they find out where their post-graduate education will take place. But specialties that are highly popular, have a limited number of residency positions. And therein lies the problem; “medial school enrollment has grown, but residency slots haven’t kept pace.” So there are more applicants for the same number of slots, leaving a large number of graduates unmatched and unable to continue their education.
My reference article mentions five specialties which are filling easily, but are turning away other applicants in greater numbers each year. Neurosurgery residency programs reject 31% of their applicants every year. Every residency fills its slots, but applicants exceed availability by a significant number. Dermatology, which has become a very sought-after residency, has about 550 residency slots. Derm applicants exceed that number by 16% so many would-be dermatologists have to choose another specialty or wait their turn. Ophthalmology does not use the National Residency Matching Program, but another system. This poses big problems for rejectees who have put all there hopes in another system that cannot find a different specialty for them.
Anesthesiology has a nationwide shortage of practitioners so filling residency positions is an important goal for now and the future. But only 5% of applicants fall short of acceptance. With a shortage of practitioners, there needs to be a push to train more anesthesiologists, and to do what is required to establish more spots for physicians to train.
The final residency under scrutiny is diagnostic radiology, the reading and interpretation of X-rays, MRI’s, and CT’s. The unmatched rate is 15% because of increased interest in the field from current graduates. This specialty was thought to be one replaced by artificial intelligence, but that hasn’t happened, yet. Interest in radiology has remained high because of the many options for practice one has.
What can a student do to enhance his chances of being selected for a coveted residency spot?
- Have a geographic connection to the institution at which you will be training.
- Do a rotation during med school at the institution where you want to do your residency.
- Be chosen for Alpha Omega Alpha, the med school academic excellence organization.
- Be a member of the “Gold Humanism Honor Society”
These not-so-subtle moves will signal your interest in the program and alert faculty to the sincerity of your efforts.
These factors plus excellent grades, eager participation in any benevolent programs, and being committed to the health and welfare of your patients will almost certainly gain the attention necessary to be considered for, and be accepted into, the residency of your choice.
It must be money that holds back institutions from adding additional positions in the residency program on which you pin your future. Graduates are well-positioned find a good Family Medicine program because 1 in 6 residency positions go unfilled—not the other way around as with neurosurgery, dermatology, and radiology.
References: Getting Into a Medical Residency is Harder Than Ever. Here’s Why. medscape.com 2026 June 12.
Kremer TR, Kremer MJ, Kremer KP, Mihalick A. Predictors of getting a residency interview: Differences by medical specialty..Med Education 2021 Feb;55(2):198-212.
Mascarenhas B, Puranam KS, Katehakis M Comparison of program-centric vs, Student-centric National Resident Matching Algorithms JAMA Network Open 2021 Jun 1;4(6).
Everett G, Maharam E, Yi F. National Resident Matching Program Rank Order and Performance in an internal Medicine Residency. South Med J 2021 Oct;114(10):667-661.
