Match Day 2018 marked the culmination of years of hard work for a record number of aspiring physicians. The 2018 Main Residency Match was the largest in history, according to the National Resident Match Program (NRMP), with 37,000-plus applicants submitting program choices for more than 33,000 positions. The number of available first-year (PGY-1) positions rose to 30,232, a 4.8 percent increase over 2017, and the percentage of all positions filled and percentage of PGY-1 position filled increased slightly from the prior year. The Match saw a modest increase in participation from active U.S. allopathic senior medical students, with a total of 18,818 applying. That group matched at a 94.3-percent rate, with 77.3 percent of those applicants matching at one of their top three choices. The number of applications from students and graduates of U.S. osteopathic medical schools and international medical graduates (both U.S. Citizens and non-citizens) also rose. The 90 percent club Six specialties with more than 30 available positions filled more than 90 percent of their spots with U.S. allopathic seniors: Integrated interventional radiology: 95.5 percent. Orthopedic surgery: 93.1 percent. Integrated plastic surgery: 92.9 percent. Radiation oncology: 91.5 percent. Neurological surgery: 90.2 percent. Otolaryngology: 90.2 percent. Mixed picture for primary care Almost half of all first-year positions offered are in the primary care specialties of family medicine, internal medicine, internal medicine–pediatrics, internal medicine–primary, and pediatrics. Less than half of those positions, however, were filled by U.S. seniors. The number of U.S. allopathic seniors matching in internal medicine and pediatrics has declined for four consecutive years. The number of such applicants matching to family medicine programs, however, has increased every year since 2009. Emergency medicine continues to grow This year’s Match showed emergency medicine’s strength. The specialty offered 2,278 first-year positions, 231 more than in 2017. The overall fill rate was 99.4 percent, and 70.5 percent of the positions were filled by U.S. allopathic seniors. Since 2014, the number of emergency medicine positions has increased by 492, or 27.5 percent. Other specialties charted notable growth: Psychiatry: 61 more positions, a 4.1 percent rise. Neurology: 60 more positions, up 12.2 percent. Anesthesiology: 51 more positions, up 4.2 percent. The breakdown of applicants who were weren’t U.S. allopathic seniors followed recent trends. The number of U.S. osteopathic medical students and graduates who submitted program choices was 4,617, and 3,771 (81.7 percent) matched to PGY-1 positions. Both are all-time highs. U.S. citizen international medical students and graduates (IMGs) who submitted program choices rose slightly over the prior year, with 5,075 applicants. The match rate of 57.1 percent to PGY-1 positions was the highest match rate since 1993. The number of non-U.S. citizen IMGs who participated in the Match fell for the second consecutive year. In 2018, 7,067 IMGs submitted program choices, down 217 from last year and 393 from 2016. However, 3,962 IMGs (56.1 percent) matched to first-year positions, the highest match rate since 1993. What if you don’t match Once the initial matching algorithm was processed, 1,268 of the positions were unfilled. Of those unfilled spots, 1,177 were placed in the Match Week Supplemental Offer and Acceptance Program (SOAP). Source