Changes in the Growth Rate for Emergency Medicine Residency Training Positions From 2011 to 2025

Emergency medicine (EM) has experienced considerable expansion in recent years, prompting concern among potential EM applicants. This study reports the growth rate for training positions in EM and other specialties during three consecutive 5-year periods from 2011 to 2025, with the goal of providing context for medical students and their advisors as they assess EM's growth relative to other fields.

This study analyzed National Residency Matching Program (NRMP) Main Residency Match data. The growth rate for first-year postgraduate (PGY-1) training positions was calculated for EM and eight other specialties from 2011 to 2015, 2016 to 2020, and 2021 to 2025, which correspond to the 5-year periods before, during, and after the transition to a single graduate medical education accreditation system. The percentage of total NRMP positions offered by each specialty was also calculated.

The number of EM PGY-1 positions grew by 13.3% from 2011 to 2015, 40.6% from 2016 to 2020, and 8.0% from 2021 to 2025. Among the specialties included in this analysis, EM had the sixth highest growth rate from 2011 to 2015, the second highest growth rate from 2016 to 2020, and the seventh highest growth rate from 2021 to 2025. The proportion of EM positions, as a percentage of all NRMP PGY-1 positions, decreased from 2011 to 2015, increased from 2016 to 2020, and then decreased from 2021 to 2025.

The growth rate for EM training positions offered through the NRMP increased during the transition to a single accreditation system, then slowed during the 5 years following the transition. From 2021 to 2025, the growth rate for EM positions was exceeded by anesthesiology, family medicine, general surgery, internal medicine, interventional radiology, and physical medicine and rehabilitation. These results demonstrate that the recent expansion in EM training opportunities is not unique.