Primary care recovers (a little) in national residency match
April 9, 2025
Summary: This year’s residency match shows more new doctors matching in pediatrics, and virtually all residency slots in obstetrics and emergency medicine filled in 2025.
Source: National Residency Match Program, 2023, 2024, 2025. Numbers displayed are for “categorical” internal medicine and pediatrics, which are the trainees most likely to go into primary care. This is limited to graduating U.S. medical students only.
“The Match” is an exciting and scary time for those graduating medical school. I still remember waiting with a throng of my classmates outside the medical school mailboxes in mid-March at my medical school for the slip of paper that would tell me where I would spend the next three years. The National Residency Match Program has used a mathematical algorithm to pair graduating medical students with training programs for decades, and results are now distributed efficiently by email.
The Match has not been kind to primary care in recent years. Last year, 5% of internal medicine residency positions, 12% of family medicine residency positions, and 8% of pediatric residency positions remained unfilled at the end of the match. Each of these training programs produce both primary care physicians and hospitalists, and some graduates go on to specialty training. Some of the vacancies were filled in the “scramble,” where unmatched medical students, foreign medical graduates or recent U.S. graduates who had not yet started training compete for open spots. But many remained unfilled, even though the country continues to face a primary care shortage.
This year, the results are a bit better, especially in pediatrics. Total number of primary care slots increased by 4.7%, and number of matched senior medical students increased 5.6%. Emergency medicine residency programs, which filled under half of their slots in 2023 in the aftermath of the pandemic, are back up to 98% filled. Only a single Obstetrics and Gynecology training slot went unfilled in 2025.
Source: National Residency Match Program, 2025 This includes graduating medical students only, and is limited to categorical IM and Pediatrics residency slots.
Implications for employers:
Continued shortfalls in residency matching in primary care point to a need for innovations that will better use technology and non-physicians so that the needs of employees and their families can be met.
Employers should be cautious about plan designs that require more primary care capacity, as primary care capacity might not be adequate to meet those plans’ needs.
Advanced practice clinicians can help address the shortage of primary care physicians, although APCs are increasingly choosing to go into specialties.
Tomorrow: Hospitals with inclusive policies had less nurse burnout