Have you every wondered whether it has been getting more difficult lately to get into a US residency program? What's the data to support or refute this statement?
To answer this question, lets look at NRMP data (below)
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The notable findings in this report are as follows:
1. The length of the ROL (rank order list) in Table 1 for the filled PROGRAMS has been steadily increasing from 9.24 (in 2002) to 13.12 (in 2019) rankings for one position i.e. in 2019, to successfully MATCH one applicant into a residency position, a program had to rank 13.12 candidates for that position.
What does this mean? Clearly there are more residency positions than before (see my blog titled 'Is 2020 a good year for medical residency training in US?') so more rankings per position cannot be explained by a decrease in the denominator.
In my opinion, the above data suggests that nowadays programs are ranking more applicants as the program directors feel that applicants now have more choices to pursue at different programs and locations. So, to improve the chances that a program will successfully match the number of applicants it needs and that there are no unfilled positions, programs are betting more i.e. ranking more applicants.
To throw a wrench in this line of reasoning, the data reports states that 'NRMP advises applicants and programs to include all acceptable choices on their rank order lists. A
longer ROL in no way affects the chances of matching to choices higher on the ROL.' I think this is a way of asking the programs to continually improve the quality of residency education to get the most and best suited applicants.
2. The length of ROL for the applicants is even more interesting. Again, the data tables 2 and 3 in this report show that the length of ROL for matched US seniors increased from 7.96 (in 2002) to 12.91 (in 2019). That is, a US senior is now ranking more programs than before.
In my opinion, the above finding is a clear sign that matching into a US residency program is now MORE competitive. Other data to support my above conclusion is the fact that unmatched applicants had shorter ROL and ranked close to half the number of programs as compared to matched US seniors (6.90 for the former and 12.91 for the latter as in table 3).
Data for IMGs is not provided in this report. One could extrapolate from the 2019 data (tables 2 and 3) that if the average length of ROL for the entire matched applicants was 11.22 and the average length of ROL for the matched US seniors was higher at 12.91, then on average, independent applicants (US medical graduates, DO, US IMGs, non-US IMGs) had shorter ROL and ranked fewer programs.
It is a no-brainer that if you rank fewer programs, you have less chance of matching. But why would one rank fewer programs? Are independent applicants more confident of matching as compared to US seniors? I don't think so - in my opinion, independent applicants are less preferred i.e. ranked lower when compared with US seniors and likely had fewer interviews. I certainly hear this in regards to non-US IMGs whom I have interacted with during observership (see my earlier blog titled 'Observership - what is it like in an academic hospital?'). The following figure from NRMP supports my above speculation. It shows that independent applicants applied to more programs than US seniors, but interviewed less and ranked fewer programs than US seniors. 
To summarize, YES, it is getting more competitive for both programs and applicants to have a successful match and this trend has greater impact on IMGs.
I wish I could give you better news, but the take home message is that 'strengthening your resume, scoring well on the exams and having a stellar interview performance at every program you interview are your best shot at beating the crowd'.
Go to www.ed4medus.com to learn more about personalized services offered and find out how Ed4Med LLC can help you get into a US medical residency program.
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Before you go: Here's your golden opportunity to have your voice heard. Write down your ONE question regarding your US residency program application, personal statement, interviews or anything that has been bothering you and keeping you up at night. You can reply at the end of this blog or post a message at my Facebook page.
The top 10 popular questions will be featured on my next blog posts at https://ed4medllc.blogspot.com/ and the winners will receive a coupon each for a FREE practice interview at Ed4medus.com ! Put those thinking caps on and hurry up!
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