Residency Match Trends, Racial Disparity, and Matching Amid a Pandemic

Radiation oncology has been facing an evolving crisis in recruitment for several years, and the events of 2020 to 2021 will certainly add to that crisis with the urgency of addressing systemic racial injustice amid a global pandemic. The purpose of this study is to examine applicant data to gain insight on residency match trends and evaluate these findings within the backdrop of a novel match year.

National Residency Matching Program (NRMP) data between 2009 and 2020 were assessed for the number of applicants, programs, and positions available, number of ranked applicants needed to fill positions, and successfully matched applicant data. Additionally, Electronic Residency Application Service data were evaluated for race/ethnicity identification among applicants.

The number of applicants who ranked radiation oncology as their preferred specialty has declined for 3 consecutive years from 223 in 2017 to 155 in 2020. In 2020 the applicant-to-position ratio was at an all-time low at 0.82, and the unmatched position rate increased to 18.5%. The percentage of Black or African American applicants applying to radiation oncology has also declined to 4.9%, and this population represents 7.2% of all applicants. The number of ranked applicants needed to fill the available radiation oncology PGY2 positions increased from 4.0 in 2010 to 6.0 in 2020.

Declining interest in radiation oncology among applicants, and an even further decline of black applicants, along with the challenges of interview and travel restrictions during the pandemic provide heightened concern for this year's match. Innovative efforts to expand the reach of radiation oncology to prospective applicants is needed to engage diverse, bright, and committed students for the continued progress of radiation oncology and most importantly, our patients.