Competitive Residency Match Rate: Does Having a Home Program Make a Difference? (Preprint)

Abstract

On average, competitive specialties have significantly lower match rates, and the competitiveness continues to rise each year. Besides test scores, applicants need to demonstrate interest in research, leadership, and clinical experience—opportunities often more accessible at schools with a home residency program.

This study assesses how home programs impact residency match rate for competitive specialties, aiming to enhance program directors’ assessment of applicants, guide medical school advisors, and aid students in strengthening their residency candidacy.

12,489 US MD medical school graduates from 2019 to 2023 were assessed retrospectively. Match lists published on each institution’s official website and the Office of Student Affairs provided data for 152 US MD programs. Characteristics examined included Alpha Omega Alpha and Gold Humanism Honor Society chapter status, home residency program, and number of specialty faculty. An odds ratio (OR) analysis was conducted to determine the likelihood medical students with a home program matched into a competitive specialty compared to those without.

984 competitive residency programs had school affiliations and 660 lacked affiliations. Of the matched applicants in a competitive specialty, 10,541 attended an institution affiliated with a residency program resulting in a statistically significant 2.0% match rate for students with a home program versus 1.1% match rate for students without a home program (OR: 1.73) (p<0.01). Applicants with and without a home program matched 58.3% and 52.7% into academic (OR: 1.25), emphasizing the advantageous impact of a home program.

US MD graduates with a home program were nearly twice as likely to match into their competitive specialty of choice, possibly attributed to more clinical exposure, strong faculty relationships, and application support. This study demonstrates lack of a home program disadvantages applicants and may contribute to disparities in acceptances in competitive specialties.