ASA’s Center for Anesthesia Workforce Studies (CAWS) reports trends in anesthesiology resident matches after the release of the National Resident Matching Program (NRMP) Results and Data report published in May or June each year (asamonitor.pub/3xD16Ye). This report summarizes data on candidates who filled residency positions between 2003 and 2022. Resident match data prior to 2003 are available in the August 2018 ASA Monitor (ASA Monitor 2018;82:42-6).
Match results signaled strong demand for anesthesiology residency programs. Key metrics include growth in the number of applicants and positions offered, increase in the percentages of positions filled, and applicants not matched. In 2022, a total of 4,861 candidates applied to 1,980 anesthesiology positions and filled all but seven available positions. The number of anesthesiology positions offered increased 7% between 2018 and 2022.
Table 1 summarizes the number of applicants and the type of candidates who matched into anesthesiology between 2013 and 2022 (e.g., U.S. allopathic seniors, osteopathic students or graduates, other, and international. See Exhibit for definitions). In 2022, 1,973 candidates matched, a 9% increase over 2018; it was the greatest number of matched candidates into the specialty to date. The percentage of matches by U.S. allopathic seniors and osteopathic students or graduates between 2018 and 2022 steadily increased (5%); they represent 84% of anesthesiology matches in 2022. For all other specialties, in aggregate, the percentage of matches by U.S. allopathic seniors and osteopathic students or graduates varied between 74% and 75% between 2018 and 2022.
From 2014 to 2017, the number of candidates from international medical schools matched into anesthesiology increased substantially. 2022 marked a 36% decline in matched candidates who graduated from non-U.S. medical schools, compared to 2018, and was the lowest reported to date. 162 (8%) matched candidates graduated from non-U.S. medical schools in 2022, compared to 255 (14%) candidates in 2018.
Less than 42% of all candidates who applied to an anesthesiology program matched in 2022 (Figure 1). Residency programs in neurology and dermatology had a similar percentage of applicants matching as anesthesiology, indicating a high demand for these specialties. When evaluating the percentage of non-matched candidates to only PGY-1 programs with more than 200 applicants in the 2022 match year, anesthesiology ranked 13th out of 25 total programs, with 45% non-matched (ranked in descending order). Emergency medicine had the lowest percentage of non-matched and dermatology had the highest, 12% versus 91%, respectively (data not shown).
“The position fill rate in the last decade was very high, ranging between 94% and 100%, reflecting a consistently strong preference for the specialty.”
Between 2003 and 2022, the number of anesthesiology residency positions increased 57%, from 1,264 to 1,980 (Figure 2). Though the number of anesthesiology applicants increased 62% between 2008 and 2021, a slight decline was observed between 2021 and 2022 (Figure 3). There were similar applicant declines in 2022 in family medicine, neurology, pediatrics, and psychiatry programs (data not shown). Emergency medicine had the sharpest decline, with 18% fewer applicants compared to 2021. The number of anesthesiology programs more than doubled in the last two decades, with a reported 73 programs in 2003 and 165 programs in 2022 (data not shown).
Since 2003, anesthesiology residency programs have filled more than 90% of positions each year. The highest anesthesiology position fill rate was 100% in the 2021 and 2022 match years; 2020 had the second-highest fill rate at 99% (Figure 4). The anesthesiology position fill rate in 2022 was comparable to several specialties, including orthopedic surgery, diagnostic radiology, general surgery, obstetrics-gynecology, physical medicine and rehabilitation, and psychiatry (Figure 5). Family medicine had the lowest percentage of residency positions filled (91%).
Trends in anesthesiology resident match results are useful for indicating an increase to the supply pipeline and may represent a lagging indicator of demand for the specialty. This report shows that the overall total number of matched candidates continues to grow, with the percentage of matched U.S. allopathic seniors and osteopathic students or graduates (84%) increasing by 5 percentage points in 2022 compared to 2018 (79%). Since 2003, anesthesiology programs have increased the number of positions offered every year, except for small decreases in 2005 and 2016. The position fill rate in the last decade was very high, ranging between 94% and 100%, reflecting a consistently strong preference for the specialty.
EXHIBIT Definitions of Applicant and Position Types
- 5th Pathway (Graduate of Fifth Pathway Program) – Graduate of a U.S. Fifth Pathway program.
- Canadian (Student/Graduate of Canadian Medical School) – Senior student or graduate of a Canadian school of medicine accredited by the Committee on Accreditation of Canadian Medical Schools (CACMS).
- Non-U.S. IMG (Non-U.S. Citizen Student/Graduate of International Medical School) – Non-U.S. citizen who attended an international medical school.
- Osteopathic (Senior/Graduate of Osteopathic Medical School) – Senior student or graduate of a medical school accredited by the Commission on Osteopathic College Accreditation (COCA).
- U.S. Grad (Previous Graduate of U.S. Allopathic Medical School) – Graduate of a U.S. allopathic school of medicine accredited by the Liaison Committee on Medical Education (LCME) with a graduation date before July 1 in the year before the Match. The medical school does not sponsor previous U.S. graduates.
- U.S. IMG (U.S. Citizen Student/Graduate of International Medical School) – U.S. citizen who attended an international medical school.
- U.S. Senior (Senior student of U.S. Allopathic Medical School) – Fourth-year medical student in a U.S. allopathic school of medicine accredited by the LCME with a graduation date after July 1 in the year before the Match. U.S. seniors are sponsored by their medical schools.
- PGY-1 and PGY-2 – Postgraduate year one and postgraduate year two programs.
- Physician (R) – Programs reserved for physicians who have had prior graduate medical education. Reserved programs offer PGY-2 positions that begin in the year of the Match and thus are not available to senior medical students.