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Trends and Outcomes in Residency Matches: Assessing the Post-Merger Landscape for DO and MD Graduates
June 2026 | Vol. 70, No. 2
Haley S. Jerman, M.S., PA-C, OMS II
Katlyn E. Yebernetsky, M.S., PA-C, OMS II
Shaun-Marie T. Wilson, M.P.H., PA-C, OMS II
Sarah Rosmarin, M.S., PA-C, OMS II
Christopher B. Divito, Ph.D., Assistant Professor of Basic Science
All authors are affiliated with the College of Medicine at Lake Erie College of Osteopathic Medicine at Seton Hill, Greensburg, PA.
Abstract
Context: The effects of the American Osteopathic Association (AOA) and Accreditation Council for Graduate Medical Education (ACGME) merger on match rates for osteopathic (DO) graduates have yet to be fully elucidated. The goal of the merger was to increase equity between DO and allopathic (MD) graduates. Subsequent to the merger, concerns remain regarding parity among DO and MD graduates.
Objectives: To examine trends in residency placements, we analyzed pre- and post-merger match rates for dermatology, neurological surgery, orthopedic surgery, radiology, anesthesiology, and obstetrics-gynecology (OB/GYN) residencies for both DO and MD graduates.
Methods: Data were compiled from the National Resident Matching Program (NRMP) from 2014–2024 and the National Matching Service (NMS) for 2014–2019. Additionally, yearly totals of osteopathic and allopathic graduates from the American Association of Colleges of Osteopathic Medicine (AACOM) and the Association of American Medical Colleges (AAMC) were collected. All data were analyzed by linear regression analysis, Spearman’s correlation, and Mann-Whitney U tests using Prism v10.
Results: Correlation analyses of the number of DO and MD filled competitive residency positions for dermatology, neurosurgery, and orthopedic surgery were performed. With the exception of orthopedic surgery (Regression: y = 0.005x + 3.4; r2 = 0.001; Spearman’s: r = -0.009, n = 11 pairs, p = 1.0), the percentage of DOs filling traditionally competitive residency positions was negatively correlated over the last eleven years (Dermatology: Regression: y = -0.2x + 464.0; r2 = 0.3; Spearman’s: r = -0.6, n = 11 pairs, p < 0.05; Neurosurgery: Regression: y = -0.6x + 1286; r2 = 0.8; Spearman’s: r = -0.9, n = 11 pairs, p < 0.001). Moreover, when match data was binned pre- and post-ACMGE merger, there were significantly fewer DO positions filled post-merger for each highly competitive specialty, except orthopedic surgery. Conversely, diagnostic radiology, anesthesiology, and OB/GYN all reported a positive correlation of DO match rates with time (Radiology: Regression: y = 0.4x – 888.6; r2 = 0.6; Spearman’s: r = 0.7, n = 11 pairs, p = 0.01; Anesthesiology: Regression: y = 0.5x – 968.4; r2 = 0.4; Spearman’s: 0.6, n = 11 pairs, p = 0.0562; OB/GYN: Regression: y = 0.4x – 715.2; r2 = 0.6; Spearman’s: r = 0.8, n = 11 pairs, p = 0.004 ) and either a statistically significant increase in DO-filled positions (Radiology: U = 2, p = 0.01; OB/GYN: U = 3, p = 0.03) or a positive trend (Anesthesiology: U = 7, p = 0.2). Although a positive correlation was also observed with MD-filled positions and time, no significant increase pre- versus post-merger was observed (Radiology: U = 13, p = 0.8; Anesthesiology: U = 7, p = 0.2, OB/GYN: U = 12, p = 0.7).
Conclusion: The ACGME merger generated variable impact on osteopathic representation in competitive specialties. While osteopathic graduate numbers have increased, their representation in competitive residencies has declined post-merger. Conversely, there was a significant increase in traditionally less competitive residency programs. Our study highlights the ongoing imparity between match rates for DO and MD graduates.
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