The residency match is an integral step in the journey to becoming a practicing physician. By understanding its origins, recognizing the challenges and taking proactive steps to manage stress, medical graduates can navigate The Match with greater confidence — and set the stage for a fulfilling career in medicine.
This year’s Match Day is today, March 21, 2025. So what is Match Day? How did it come about? And why does it have to be so stressful? Check out this explainer to learn all about it.
What is Match Day?
Every March, thousands of medical school seniors across the United States learn where they will spend the next several years of their training. This highly anticipated event, known as Match Day, is administered by the National Resident Matching Program. The NRMP uses a computer algorithm to pair medical graduates with residency programs based on mutual preference lists submitted by both students and programs.
On Match Day, graduates find out whether they matched with their top choices or if they need to participate in the Supplemental Offer and Acceptance Program, commonly known as SOAP, for unfilled positions. Emotions run high, with some celebrating coveted placements while others scramble to find suitable residencies.
How many physicians get matched each year?
While the exact number varies annually, the NRMP consistently places tens of thousands of medical graduates into residency programs.
According to the NRMP’s preliminary data for 2024:
- Positions Offered: Approximately 41,300, an increase from around 40,375 in 2023.
- Active Applicants: About 44,500 individuals, including U.S. MD seniors, U.S. DO seniors, and international medical graduates.
- Positions Filled: Roughly 38,200, leading to an overall fill rate near 93%.
- U.S. MD Seniors: Approximately 93.5% matched with a residency program.
- U.S. DO Seniors: About 86.7% secured a match.
- International Medical Graduates: Match rates varied, with U.S. citizen IMGs around 61% and non-U.S. citizen IMGs near 59%.
These figures reflect a continuing trend of incremental increases in both the number of positions and applicants. Final numbers, which may differ slightly, are typically released by the NRMP later in the year. Overall, Match Day remains a pivotal event for thousands of aspiring physicians, determining where they will begin their formal residency training.
Origins of Match Day
The modern matching process dates to the 1950s, when the NRMP was created to address an increasingly complex and competitive environment for residency placement. Prior to the NRMP, medical students and hospitals often engaged in early or “exploding” offers, which pressured students to accept placements quickly without comparing options. Over time, the matching algorithm was refined to better ensure an equitable system for both applicants and residency programs.
Match Day challenges for medical school graduates
- Competitive Specialties: Applicants face intense competition for residency spots in specialties such as dermatology, orthopedic surgery and neurosurgery. This can lead to high levels of stress and uncertainty.
- Geographic Restrictions: Some graduates must remain in a certain region due to family or financial considerations, limiting their options.
- Debt and Financial Pressures: According to the Association of American Medical Colleges, the median medical school debt among graduates is more than $200,000, which can exacerbate anxiety and influence a graduate’s choice of specialty or residency program.
- Emotional Stress: The pressure to succeed, coupled with the uncertainty of the match, can take a toll on mental health.
What is the Electronic Residency Application Service?
The Electronic Residency Application Service, commonly referred to as ERAS, is a centralized, online application portal administered by the Association of American Medical Colleges. Medical graduates use ERAS to submit their application materials, including personal statements, letters of recommendation and transcripts, to the residency programs they wish to pursue.
How ERAS fits into Match Day
- Centralized Submission: Instead of sending individual applications to each program, applicants upload all required materials to ERAS. Programs then access these materials through a secure portal.
- Timeline Coordination: ERAS opens each year on a set date, allowing applicants to upload documents and assign them to specific programs. Residency programs begin reviewing applications shortly afterward, typically between September and October.
- Interviews: Programs use the information in ERAS to decide which candidates to invite for interviews. After interviews conclude, applicants and programs submit their rank lists to the National Resident Matching Program.
- Results: On Match Day, applicants learn where they have been matched for residency. For those who do not match, ERAS remains an important tool for quickly applying to unfilled positions through the Supplemental Offer and Acceptance Program.
Through ERAS, medical graduates benefit from a streamlined application process, ensuring programs have a consistent, comprehensive view of each candidate’s qualifications.
What if I don’t get matched?
Match Day marks the start of a new chapter. Even for those who do not immediately match or secure their first choice, alternative paths exist. The SOAP process can help graduates find unfilled positions, and some may consider research years or other opportunities to bolster their resumes.
Getting ready for Match Day 2026: Tips for managing stress from The Match
For med students who are looking ahead to Match Day 2026, here are some tips for managing the application process and confronting the stress and anxiety of the process:
- Plan ahead: Early in the application cycle, research programs that align with your career goals, geographic preferences and personal values. Create a realistic rank list that balances “reach” programs with those where you have a strong chance of matching.
- Seek mentorship: Faculty advisors and residents in your desired specialty can offer insight about programs, help refine your personal statement and prepare you for interviews.
- Stay organized: Keep a detailed schedule of application deadlines and interviews. Use spreadsheets or project management tools to track each program’s requirements, costs and follow-up steps.
- Find emotional support: Talk to classmates, friends, family or a counselor. Sharing anxieties and experiences can help normalize the stress you may be feeling.
- Practice self-care: While it may be tempting to dedicate all your time to applications and interviews, taking breaks to exercise, meditate or engage in a hobby can reduce burnout and improve overall well-being.
Understanding the SOAP process
When medical graduates do not match into a residency program through the initial algorithm, they can participate in the Supplemental Offer and Acceptance Program, commonly known as SOAP. This program is managed by the National Resident Matching Program and provides a structured process for filling residency positions that remain vacant after the main match results are released.
Students become eligible for SOAP when they learn they have not matched. Beginning on Match Week’s Monday, candidates can receive offers from programs with unfilled positions, and they typically have a short window to accept or decline. The process continues through several offer rounds, usually wrapping up before Match Day on Friday.
How SOAP works
- Notification of Eligibility: Graduates who do not match receive an alert from the NRMP.
- Program Listings: The NRMP releases a list of programs with unfilled positions to all SOAP-eligible applicants.
- Applications and Interviews: Candidates can apply to these programs through the Electronic Residency Application Service. Some programs may conduct virtual or phone interviews to assess applicants.
- Offer Rounds: During each round, programs extend offers to selected applicants. If an applicant rejects an offer or does not respond within the time limit, programs may move on to other candidates.
Key considerations for the SOAP process
- Timeliness: The window to accept an offer is short, so staying organized is crucial.
- Professionalism: Maintain clear, concise communication with program directors, as impressions during SOAP can influence your acceptance.
- Flexibility: Programs may not be in your preferred location or specialty. Keep an open mind, as securing any accredited residency can be a stepping stone to future success.
- Follow-up: If you remain unmatched after SOAP, explore research or fellowship opportunities to strengthen your application for the next match cycle.
For those who do not secure a residency position on Match Day, SOAP can provide an important secondary pathway, offering additional opportunities to launch a medical career.
