2026 Residency Match Results: What the Numbers Mean for Your Specialty

The 2026 NRMP Main Residency Match was the largest in history: 44,344 positions offered, 41,482 filled at a 93.5 percent overall fill rate, and 38,354 applicants matched to a PGY-1 position. The headline story sits in two places. Family Medicine continued a multi-year contraction, filling 83.6 percent of its 5,491 positions and triggering NRMP to convene a 2026 Blue Ribbon Panel on the specialty. Psychiatry kept expanding (97.4 percent fill of 2,516 positions, an increase of 128 positions over 2025). US MD seniors matched at 93.5 percent, unchanged since 2024. US DO seniors hit a record 93.2 percent (up 0.6 points), and US-citizen IMGs hit a record 70.0 percent (up 2.2 points). Non-US-citizen IMGs requiring visa sponsorship matched at 54.4 percent, a five-year low.

This article reads the 2026 numbers without spin. It walks through the headline fill rates, the multi-year specialty trends, IMG-specific access, and what MS3s choosing specialties right now should take from the data.

2026 Match by the Numbers

Here is the high-level summary, drawn directly from the NRMP 2026 Match by the Numbers release.

The combination worth flagging: total positions and total matches both grew, but unfilled positions grew faster (+15.7 percent year over year). Programs added capacity faster than the applicant pool grew.

How Did the 2026 Match Compare to 2025 and 2024?

The big shifts year-over-year sit in three places.

First, the supply side. Programs added 1,085 PGY-1 positions, the largest single-year increase in recent memory. Most of the growth came from Emergency Medicine, Psychiatry, and Internal Medicine. NRMP certified 6,809 program tracks, an increase of 183 from 2025.

Second, the applicant side. US MD senior submissions rose 2.8 percent, US DO senior submissions rose 1.3 percent, and non-US-citizen IMG submissions rose 4.2 percent. US-citizen IMG submissions dropped 8.2 percent, the only major applicant category to shrink.

Third, the unfilled rate. With supply growing faster than demand, 2,862 positions ended Match Day unfilled, 389 more than in 2025. Of those, 2,851 were offered in the Supplemental Offer and Acceptance Program during Match Week.

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Most Competitive Specialties in 2026

Competitiveness is a function of two numbers: fill rate (high means programs got the applicants they wanted) and applicant profile (high means the matched cohort had high scores, research, or both). For 2026, the high-competitiveness tier looks familiar.

Surgical subspecialties, Dermatology, Ophthalmology, Radiation Oncology, and Plastic Surgery (Integrated) continue to fill at or near 100 percent in 2026, with matched applicants showing the highest mean Step 2 CK scores and the highest research output. None of those specialties expanded materially in 2026. The competition is the same kind of fierce it has been since at least 2020.

Specialties Where the Match Got Easier in 2026

Easier is the wrong word. Fill rates dropped in several large specialties, which means more positions remained open at the end of the algorithm, which means more post-SOAP availability for re-applicants and SOAP candidates. That is different from ‘easy to match.’

Family Medicine is the clearest example. The fill rate dropped 1.4 points to 83.6 percent, leaving 899 unfilled positions before SOAP. Internal Medicine fill rate dropped 1.6 points to 95.2 percent. Emergency Medicine, despite growing 1.8 percent in matched applicants, saw its fill rate slip 2.3 points to 95.6 percent because programs added capacity faster than applicants applied.

For applicants who genuinely want primary care, the 2026 cycle is a stronger market than 2024 or 2025 was. For applicants treating primary care as a fallback, this is the same trap it has always been: a half-hearted application is visible to program directors, and ‘safety pick’ framing reduces interview yield.

Primary Care Fill Rate Trends — Family Medicine, Internal Medicine, Pediatrics

The Family Medicine fill rate is the headline story of the 2026 cycle. Family Medicine filled 83.6 percent of its 5,491 positions, the lowest fill rate of any major specialty and a 1.4-point drop from 2025. NRMP announced in March that it will convene a Blue Ribbon Panel in 2026 to examine the structural factors driving declining medical student interest and workforce sustainability concerns in Family Medicine. Read the AAFP, AAMC, and NRMP commentary together: the contraction is real, it is multi-year, and it is concentrated in rural and lower-pay programs.

Internal Medicine remains the dominant pathway by sheer volume. With 11,632 positions, it offers more than any other specialty by a wide margin, and continues to fill above 95 percent. The 1.6-point drop in 2026 is structurally similar to Family Medicine’s (specialty growth outpaced applicant growth) but the overall picture is healthier.

Pediatrics (categorical) filled 3,006 of 3,185 positions for a 94.4 percent fill rate, a 0.9-point drop from 2025. Pediatric subspecialty match data follows in the Specialties Matching Service report later in the spring.

Psychiatry, Emergency Medicine, and the Surgical Specialties

Psychiatry continued its multi-year expansion in 2026. The specialty added 128 positions and filled 97.4 percent of them, the highest fill rate among large specialties. The implication for MS3s considering psychiatry is that the specialty’s center of gravity is shifting — more programs, more positions, broader academic distribution. Competitiveness remains high but the pathway is wider than it was three years ago.

Emergency Medicine grew in matched applicants (+1.8 percent) but expanded positions faster, which dropped its fill rate by 2.3 points. The story to read into this is not ‘EM got easier’ but ‘EM got bigger.’ The recent run of negative press on emergency medicine workforce conditions appears to have stabilized, though future cycles will tell whether the recovery is durable.

Surgical subspecialties (Orthopedics, Plastic Surgery Integrated, Neurosurgery, ENT, Vascular Surgery Integrated, Thoracic Surgery Integrated) and the non-surgical high-competitiveness specialties (Dermatology, Radiation Oncology, Ophthalmology) stayed where they have been: small, full, high-score-required.

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How Did IMGs Fare in the 2026 Match?

The IMG story has two divergent lines in 2026. US-citizen IMGs matched at 70.0 percent, a record high (up 2.2 points from 2025) — the data point that US graduates of international medical schools have been waiting on for a decade. Non-US-citizen IMGs requiring visa sponsorship matched at 54.4 percent, a five-year low and a 1.6-point drop from 2025. Non-US-citizen IMGs not requiring visa sponsorship (US permanent residents) matched at 67.9 percent, a five-year high.

The pattern reads cleanly: programs continued to admit IMGs in roughly the expected proportion, but those IMGs were increasingly drawn from the visa-not-required cohort. For visa-requiring applicants, the strategic implications carry forward — apply broadly, apply to programs with documented visa-friendly history, and consider US permanent residency pathways where the timeline allows.

What Scores and Research Profiles Were Competitive in 2026?

The detailed Charting Outcomes in the Match for 2026 is the source document for score and research benchmarks per specialty. NRMP typically releases Charting Outcomes in the months following Match Day, so the 2026 edition will be publishedpublish over the summer. The 2024 edition (the most recent fully published) gave the following ranges, and we will update this article when the 2026 edition is available:

Mean Step 2 CK scores for matched US MD seniors clustered above 250 for the most competitive specialties (Dermatology, Plastic Surgery Integrated, Orthopaedic Surgery, ENT), in the 240s for the middle tier (Anesthesiology, Radiology, Ophthalmology, EM, OB/GYN), and in the 230s for the larger primary-care specialties. Research output (publications, abstracts, presentations) tracked the same gradient. The new Step 2 CK passing standard of 218 (effective July 2025) does not change these benchmarks for the matched cohort — strong scores still matter where they always have.

What These Numbers Mean for MS3s Choosing Specialties Now

Three honest takeaways for a third-year choosing now.

First, primary care is a real opportunity in 2026, not a fallback. The fill-rate drop in Family Medicine and Internal Medicine signals that programs are looking for committed applicants, not that the bar dropped. If your clinical experiences tell you primary care is your career, the 2026 market rewards that conviction.

Second, Psychiatry and Emergency Medicine are expanding, for different reasons but both with growing program rosters. If either specialty was on your maybe list, the 2026 data tilts the decision toward ‘apply.’

Third, the high-competitiveness specialties are unchanged from a competitiveness perspective. Dermatology, Plastic Surgery Integrated, Orthopaedic Surgery, ENT, Neurosurgery, and Radiation Oncology still require high scores, strong research, and target-specialty audition rotations. The 2026 cycle does not lower the bar.

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Frequently Asked Questions

What was the overall match rate in 2026?

Overall PGY-1 fill rate was 93.3 percent, with 38,354 PGY-1 positions filled out of 41,126 offered. Among active applicants who certified rank order lists, 79.8 percent matched to a PGY-1 position.

How many positions went unfilled in 2026?

2,862 total positions went unfilled at the end of the algorithm (an increase of 389 from 2025), with 2,851 offered in the Supplemental Offer and Acceptance Program during Match Week.

Which specialty had the largest position growth in 2026?

Among the large specialties, Psychiatry added 128 positions and Internal Medicine and Emergency Medicine added significant capacity. Full specialty-by-specialty growth data is in the NRMP Advance Data Tables.

Did the Match algorithm change in 2026?

No. The matching algorithm is unchanged. What shifted was the supply-and-demand balance, with positions growing faster than the applicant pool.

Where can I find specialty-level data for 2026?

NRMP publishes Match by the Numbers, Advance Data Tables, and Match Results by State, Specialty, and Applicant Type as free PDFs in March each cycle. Charting Outcomes in the Match (with score and research benchmarks per specialty) typically publishes later in the spring or summer.