2025 NRMP Match Data Analyzed: 5 Key Trends

Another Match cycle has concluded, leaving behind a wealth of fresh insights. Let’s analyze the comprehensive 2025 NRMP data. In this breakdown, we’ll pinpoint the key trends that are now taking shape in residency admissions.

1 | DO Students are Matching Similar to MD Students

First, there is a great deal of discussion about DO match rates inching closer to MD match rates and what this could mean for the future.

To give some context, in this most recent cycle, DO students matched at a rate of 92.6%, up from 89.1% in 2021. This 3.5% increase over 4 years might not seem like much until you look at the raw number of matched applicants.

The raw numbers show a massive increase from 6,327 DO applicants who matched in 2021 to 7,773 DO applicants matching in this most recent cycle. That’s an insane 23% increase, or roughly 1,445 students.

This is notable because the data show that even though more DO students are applying to match now than ever before, the number of DO students applying doesn’t seem to impact their match rate. If anything, some have argued that more DO students applying to match is actually helping their match rates, as program directors could be getting familiar with these schools.

Now, let’s compare these numbers to the number of MD students who matched. In 2021, 18,435 MD students matched, which was 92.8% of the total number of MD applicants. This past year, just over 19,000 students matched, at 19,044, with a match rate of 93.5%, representing a 0.7% increase from the previous year. Across 4 years, the total number of MD students matching increased by a modest 3.3%, or 609 students.

That’s still roughly 2.45 USMD matches per 1 DO match. So yes, DO students are closing the gap on MD students with their overall match rate, which is great, but the sheer number of MD students still going into residency outweighs this whole discussion.

Which brings up the point on what DO students are matching into. Have they been able to break into more competitive specialties, such as dermatology, neurosurgery, ENT, and plastic surgery? Or are they still predominantly in traditionally DO-friendly residencies like internal medicine, family medicine, and pediatrics?

The NRMP data show that DO students are entering the “most competitive specialties” and “least competitive specialties” at about the same rate over the past couple of years. This means that more DO students matching every year hasn’t translated to a greater percentage of DO students matching into the more competitive specialties.

So, if you’re a premed student already looking to apply to the most competitive specialties, the NRMP’s data show that attending an MD school is still clearly advantageous.

The latest Match data show that when DO students apply for the match, they are able to match at rates similar to those of MD students, but not in more competitive specialties. This is a trend we will definitely follow for years to come.

It’s a trend that’s been there for a long time, too. I remember when I matched into plastic surgery, it was a big deal for the 1 DO student who matched into plastics. In 2023, there were no DO students matching into plastics, and in 2025, there were only 2, fewer than 1%.

Don’t fall for the talking points on social media—if you’re a premed who is considering MD vs DO, I urge you to look at the data. That’s what I’m all about. Here at Med School Insiders, I strongly believe in following the data and telling it like it is.

2 | Unfilled Family Med, Pediatric, and Internal Med Spots

Another major talking point after the 2025 match cycle was the alarming number of spots in family medicine, pediatrics, and internal medicine that remained unfilled. The reason this is being brought up is that there is already a concern about a physician shortage in the coming decades.

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Let’s talk about what happens to those who are working in these understaffed fields. With 15% of family medicine positions unfilled and growing concerns about primary care shortages, the physicians who do choose these specialties face increasing patient loads, administrative burdens, and ultimately, burnout.

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Back to the primary care match data.

Family medicine is the big one with 805 of its 5,357 spots going unfilled. That’s roughly 15% of all family medicine spots. Compared to pediatrics, 147 of its 3,135 spots went unfilled, or about 4.7%. Lastly, internal medicine has 357 of its 10,941 spots remaining unmatched, or about 3.3%.

Of all the categorical residency programs, meaning programs where you are at the same institution from the start of your intern year to the last day of residency, these unfilled rates are some of the highest by far. But let’s compare these unfilled rates to the last couple of years to see if there’s a trend or if the data are telling us this is a one-time anomaly.

In 2023, family medicine had 217 of its 5,088 spots go empty, pediatrics had 86 out of 2,986, and internal medicine had 380 out of 9,725. The percentages were 4.3%, 2.9%, and 3.9%, respectively.

In 2021, family medicine had 351 out of 4,823, pediatrics had 41 out of 2,901, and internal medicine had 392 out of 9,024 go unmatched. The percentages were 7.3%, 1.4%, and 4.3%, respectively.

Based on this data, there have been more unfilled spots in family medicine and pediatrics, while internal medicine has actually seen fewer unfilled spots. To speculate a bit, people who would have applied for family medicine and pediatrics in the past might be choosing to apply for internal medicine, or they could be applying for something outside of primary care entirely.

Now, let’s examine the family medicine unfilled rate more closely.

Looking at this chart, it’s clear that the 2025 unfilled percentage is an outlier from the previous 14 years, but it could be the first year of a larger trend away from family medicine. This sudden shift is something people have been predicting for years.

Given that primary care reimbursement rates are decreasing, there is more charting to do for every patient, and burnout is a real concern for many physicians. If you’d like to learn more about family medicine and the realities of the field, check out our So You Want To Be series, where we cover the reality of a career in family medicine.

Unfortunately, with the data currently available on the NRMP, it is impossible to accurately predict whether medical students will continue to move away from family medicine and pediatrics. Only time will tell, but we will definitely revisit this discussion after next year’s data is released.

3 | Significant Increase in Non-US IMG Applicants

Up next, since 2021, the number of non-US IMG applicants has increased from 10,718 to 14,081, a rise of more than 30%. Of course, not everyone applying to match gets an interview, and this is especially true for non-US IMGs, with 1,782 not even being able to submit a rank list because they simply don’t have any programs to rank.

To make sure we’re on the same page, non-US International Medical Graduate is the same as an FMG, or foreign medical graduate. I’ll be using the two interchangeably.

From the number of active applicants or the number of applicants who received at least one interview, the overall match rate for FMGs tends to hover around 58%. This match rate is much lower than the MD match rate at 93.5% and the DO match rate of 92.6% mentioned earlier .

This year-after-year increase in FMGs wanting to complete residency in the United States is likely due to the fact that physicians in the US tend to earn higher salaries, get arguably the best medical training with the most advanced medical technology anywhere in the world, and have a pathway to American citizenship.

The data show that Internal Medicine is the top choice for non-US IMGs, as it has not only the highest number of non-US IMG matches but also the highest proportion of students, with 3,573 matches or 34% of all positions filled. Family medicine saw around 800 FMG matches, and peds saw 590 matches. However, pathology and neurology are the two specialties, outside of internal medicine, that tend to have the highest proportion of FMG.

While it’s extremely rare for FMGs to match into top specialties like dermatology, plastic surgery, orthopedic surgery, ENT, or neurosurgery, it does happen. The few who do typically have outstanding applications — often with years of clinical experience in their home country, extensive research, and other standout accomplishments. At Med School Insiders, we’ve helped FMGs successfully match into competitive specialties, even in cases where they hadn’t previously trained in that field abroad. Some of my own colleagues and friends followed this path, and with the right strategy and support, it’s possible — though certainly challenging.

It’s worth noting that the non-US IMGs who matched this year would have applied during the fall of 2024, well before the administration changed in the US. It will be interesting to see if a similar number of non-US IMGs will apply this fall for the 2026 match. If I had to guess, I would expect to see a dip in the number of non-US IMGs applying for the next couple of years, given the current government’s attitude towards international undergraduate students.

4 | Matches in Emergency Medicine Nears Pre-Pandemic Levels

Now let’s consider emergency medicine. The so-called “Death of Emergency Medicine” occurred two years ago, when a widely shared article offered a gloomy forecast for the specialty’s future.

Coupled with COVID-19 burnout, 2023 saw a record number of emergency medicine positions go unfilled, at 554. Since then, the number of filled positions has returned to normal, especially since DO students, US IMGs, and non-US IMGs have eagerly taken on these previously unfilled emergency medicine spots. This is something I pointed out in last year’s breakdown.

What is even more interesting from this year’s data is that MD students are starting to come back to the field. Although it’s still several hundred students short of the numbers from 5 years ago in 2020, it’s a noticeable uptick.

However, the biggest trend to watch is how emergency medicine will match in the upcoming cycles. In case you missed it, the Accreditation Council for Graduate Medical Education, or ACGME, recently announced a proposal to change emergency medicine from a 3-year residency to a 4-year residency starting with the Class of 2027.

This is my new prediction for emergency medicine. There will be another “Death of Emergency Medicine” with an especially massive drop in the number of filled positions in 2027. Many students are not going to be interested in matching in emergency medicine if it means doing an extra year of training and losing a year’s attending salary, especially when their co-residents, who are a year ahead of them, don’t have to.

5 | Neurology is the Fastest-Growing Specialty

Next, we uncovered something surprising while digging through the data.

Believe it or not, the data shows neurology is the fastest-growing specialty since 2021. Over the last four years, there was a 217-spot increase, or a 30.4% growth. Although internal medicine added the most seats over that same time period, neurology is currently growing faster than every other field as a proportion of total seats offered.

Other specialties that are rapidly expanding are internal medicine and psychiatry. Basically, if the specialty you’re applying to is on this list, there’s never been a better time to apply than now.

However, I want to be clear. The number of spots a field offers, or even the number of unfilled spots, does not translate to how competitive a specialty is.

The best way to determine how competitive a specialty is is to look at the Charting Outcomes data, which is released every other year. There’s so much ego and noise when it comes to talking about hard data on which specialties are more or less competitive, with everyone being incentivized to say that their own specialty is highly competitive, when in reality, that isn’t the case.

Myself and the team at Med School Insiders painstakingly created the most comprehensive analysis of how competitive each specialty is back in 2018, and we’ve been updating it ever since. It compiles the most recent NRMP’s Charting Outcomes data to plot the average Step 2 CK score, the average number of research items, AOA status, top NIH-funded medical schools, and several other important variables to create an objective ranking of the most and least competitive specialties.

To get the complete ranking of the most competitive specialties for free, access our Medical Specialty Competitiveness Index below.

Congratulations to the graduating class of 2025. Getting through medical school is no easy feat. It’s an accomplishment very few people can claim, and I wish you all the best in residency!