The toughest fields for Match Day 2014

Despite record applications, fewer seniors matched this year than last

Medical school seniors seeking first-year residency slots faced the toughest competition for positions in neurological surgery, orthopedic surgery, otolaryngology, plastic surgery, and radiation-oncology, according to the National Resident Matching Program (NRMP).

Who's getting recruited? The nation's most in-demand specialties

On Match Day last week, 29,761 applicants were offered first- and second-year positions—500 more than in 2013 and an all-time high, according to the NRMP data. NRMP Executive Director Mona Signer says the latest numbers continue a steady upward trajectory. "In the past five years alone, we've seen an increase of more than 4,000 positions, and more than half of those are in internal and family medicine," Signer says.

According to NRMP data:

  • Internal medicine offered 6,524 positions, 247 more than in 2013. Of those positions, 99.1% filled.  
  • Family medicine saw an increase of 72 positions since last year, bringing the 2014 total to 3,109 positions. Of those, 95.8% of positions were filled.
  • Pediatrics offered 2,640 positions, 24 more than 2013. Of those, 99.5% of positions were filled.

Patrick Alguire of the American College of Physicians (ACP) cautioned that while "the number of U.S. medical students choosing internal medicine residencies continues in an upward trend, the exorbitant cost of medical education with the resulting financial burden on medical students and residents along with problematic payment models and administrative hassles are barriers to a career in general internal medicine and primary care."

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According to ACP, only 20% to 25% of internal medicine residents ultimately choose to specialize in general internal medicine over more lucrative subspecialties, such as cardiology or gastroenterology.

New trend: Fewer seniors are matching

Though the total number of applicants increased in 2014, the data show that fewer seniors matched this year than the year prior: 89 fewer seniors registered for Match day and 113 fewer submitted rank-order lists of programs.

Although the NMRP hasn't investigated the data mismatch, Signer notes that many students are remaining at school for longer than 4 years to earn a dual degree.

"It's a huge trend," Grayson Armstrong, a Brown University Alpert Medical School student, told MedPage Today. Armstrong says he and many other students are increasingly anxious over proposed reductions in government funding for graduate medical education.

Medical schools are expanding to meet demand—but will it help?

"Medical students across the nation are concerned that there won't be enough slots to train. It's not all about getting a job, it's about patients getting the care that they need," Armstrong says (Crane, Medscape Medical News, 3/24; Wickline, MedPage Today, 3/21).

Physician shortage ahead

Check out's archive of resources on the growing physician shortage:

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