Osteopathic students and graduates matching into pathology residency, 2011-2020

Abstract

Context: In the past decade, two changes have affected the pathology residency match. First, the American Osteopathic Association (AOA) Match, which did not offer pathology residency, became accredited under a single graduate medical education (GME) system with the Main Residency Match (MRM), which offers pathology residency. Second, substantially fewer United States senior-year allopathic medical students (US MD seniors) matched into pathology residency.

Objective: To determine whether there were major changes in the number and percentage of osteopathic students and physicians (DOs) matching into pathology residency programs over the past decade.

Methods: Pathology match outcomes for DOs from 2011 to 2020 were obtained by reviewing AOA Match data from the National Matching Services and MRM data from the National Resident Matching Program (NRMP). The number of DOs that filled pathology positions in the MRM was divided by the total number of pathology positions filled in the MRM to calculate the percentage of pathology positions taken by DOs.

Results: Over the past decade, there was a 109% increase in the total number of DOs matching into pathology residency (34 in 2011 vs. 71 in 2020). During this time, there was a 23.3% increase in the total number of pathology positions filled in the MRM (476 in 2011 vs. 587 in 2020). Thus, the percentage of pathology residency positions filled by DOs increased from 7.1% in 2011 to 12.1% in 2020. The substantial increase of DOs in pathology occurred simultaneously with a 94.2% increase in the total number of DOs filling AOA/MRM "postgraduate year 1" (PGY-1) positions (3201 in 2011 vs. 6215 in 2020). Thus, the percentage of DOs choosing pathology residency has remained steady (1.06% in 2011 and 1.14% in 2020). In 2020, pathology had the third lowest percentage of filled PGY-1 residency positions taken by DOs, out of 15 major medical specialties.

Conclusion: The proportion of DOs choosing pathology residency was stable from 2011 to 2020 despite the move to a single GME accreditation system and the stark decline in US MD seniors choosing pathology. In 2020, a slightly higher percentage of DOs (1.14%) chose pathology residency than US MD seniors (1.13%). Overall, DOs more often choose other medical specialties, including primary care. Additional studies are needed to determine why fewer US MD seniors, but not fewer DOs, are choosing pathology residency.

Figure 1:

The number of DOs filling pathology residency positions in the MRM, compared to the total number of pathology positions filled, years 2011–2020. MRM, main residency match.

Figure 2:

The percentage of pathology residency positions filled in the MRM that were taken by DOs, with a linear trendline. MRM, main residency match.

Figure 3:

The number of DOs filling pathology residency positions in the MRM, compared with the number of DOs filling “PGY-1” positions. “PGY-1” positions were defined as PGY-1 positions in the MRM and traditional rotating internships and Option 1 and 2 (but not Option 3) residencies in the AOA Match. Option 3 residencies were excluded because, unlike Option 2 residencies, they require a separate internship year. MRM, main residency match.

Figure 4:

The percentage of DOs matching to a “PGY-1” residency position who chose pathology residency, with a linear trendline.

Figure 5:

The percentage of residency positions filled in the MRM which were taken by DOs in year 2020. MRM, main residency match; PM&R, physical medicine and rehabilitation.