Match Day: Then & now

The third Friday of every March, thousands of senior medical students and graduates across the country anxiously await their fate: It's Match Day.

At exactly 1:00 p.m. EST Friday, March 20, students will learn the results of the National Residency Matching Program.

"It's an exciting moment because it validates their years of effort and defines their future careers as physicians," NRMP President and CEO Mona M. Signer said in a statement. "We consider it a privilege to share in this life-changing day."

Here are 10 things to know about Match Day.

1. The Main Residency Match originated in 1952. For the first match, 10,400 internship spots were open for 6,000 medical school graduates to fill, according to NRMP. The program uses a computer algorithm to optimize the matching of seniors and graduates with residency slots, based on the preferences of the students, graduates and the residency program hosts.

2. Alvin E. Roth, PhD, and Lloyd S. Shapley, PhD, won a Nobel Prize for the match algorithm in 2012. Their algorithm solves the "stable marriage problem," in which two sets of elements, such as men and women, are all matched with the best possible corresponding element. This way, there is no better match for any one element, or person, in the group. Drs. Roth and Shapley were jointly awarded The Sveriges Riksbank Prize in Economic Sciences in Memory of Alfred Nobel in 2012. Dr. Shapley is credited with developing the game theory of stability in the 50s and 60s, and applied it to "pairwise matching" with David Gale, PhD, in a paper in 1962, giving the algorithm its name: The Gale-Shapley algorithm. Dr. Roth applied the algorithm to resident matching in the 1980s and then helped the NRMP develop a new, more stable algorithm based on his research, which was implemented in 1997.  

3. Couples matching began in 1984. Couples are treated as a unit in the algorithm and rank linked pairs of programs in the same facility or area and are matched to the best pair of positions where each partner receives an offer. In 2014, 925 couples participated with a 94.2 percent match rate. In 2013, a total of 1,870 couples participated, the most couples ever.

4. Historically, the highest number of applicants to the Match was in 2014, with 40,394 applicants. Last year also boasted the highest number of post-graduate year one positions, counting 26,678 spots. It was the 12th consecutive year residency positions increased. Before that, the Match hit peak applicants in 1999 with 36,056 applicants, which then declined until 2004, when applicant numbers began climbing again, according to NRMP.

5. Last year set the record-high for active osteopathic students and graduates. 2014 tallied 2,738 osteopathic applicants, who had a 77.7 percent match rate, which is the highest in 30 years. Of those matched, more than half were matched to internal medicine (444), family medicine (394) and pediatric (290) residencies, according to NRMP.

6. For those who don't get matched, there is the Scramble, which became an "organized" Scramble in 2012. Residents first learn if — not where — they are matched with a residency on the Monday of Match Week. Students without a match were to begin at noon EST on Tuesday and scramble to find a match with a program they had not originally put as a preference. In 2009 and 2010, most spots were allotted in just four hours and filled 90 percent in 48 hours. To help settle some of the panic, NRMP launched the Supplemental Offer and Acceptance Program in 2012 to help streamline the process of obtaining an unfilled residency position. Applicants receive new offers in rounds and have two hours to accept or reject them until SOAP ends at 5 p.m. EST on Thursday of the Match Week.

7. In 2013, NRMP established the "All In" policy. Before this policy was implemented, programs could put some of their residency positions in to the Match, and keep some out to fill with independent applicants. The policy aims to help make the process fair for both programs and applicants.

8. Each medical school has time-honored Match Day traditions. The Johns Hopkins School of Medicine in Baltimore hosts an annual Match Day Brunch, while students at Eastern Virginia Medical School in Norfolk dress in costumes to honor the day. At Tulane University School of Medicine in New Orleans, each student puts $5 into a pool as they arrive at the Match Day ceremony. Students receive an envelope with their match inside one-by-one, in a random order. By Tulane tradition, the last person called wins all the money for their patience.

9. 2015 is the largest residency match of all time. A total of 41,334 applicants are fighting for just 30,000 residency positions, according to a statement from NRMP. This year, 16,932 U.S. allopathic medical school students matched to first-year positions at a rate of 93.9 percent. Osteopathic medical school students and graduates matched too: 2,949 matched, which was more than 200 more matches than last year, bringing the match rate up to 79.3 percent. Applicants who previously graduated fell from 1,662 to 1,520 and the match rate for this group also fell 4.4 percent.

10. More residency positions were offered in 2015 than ever before. Rising applicant numbers are due to increased medical school class sizes and new medical schools. To help address the rising number of graduates, more than 600 new first-year residency positions were added this year, with half in primary care. Internal medicine added 246 positions and filled 98.9 percent of them, family medicine added 86 positions and filled 95.1 percent and pediatrics added 28 positions and filled 99.5 percent.

More articles on medical residencies:

5 recently announced residency programs
Students take pay cuts for prestigious medical residencies, study shows
US needs 21% more primary care residency slots to fill shortage

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