The Unmatched MD

Unmatched: Why it Happens #match2025 #MatchDay2025 #eras2025 #unmatchedmd

DISTRESS WARNING: About 38,000 med students just found out where they got matched to residency 40 minutes ago. I’ve already spoken to one who is grateful he matched his #1 spot in his chosen field (after switching residencies & specialties after intern year). He now feels

Match Day is a milestone not a verdict. To those celebrating: congratulations. To those still searching: your career is not on hold. Opportunities exist beyond a single algorithm. And we’re committed to helping you find them. #Match2026 #UnmatchedMD #SOAP2026

Match Week etiquette reminder: Don’t text people asking if they matched. Don’t ask if it was their #1. Don’t pressure them to announce immediately. Don’t share their results before they do. This week is life-changing. Let people share and process on their own timeline

@AAMCtoday @CMSGov How many positions in a year?

Big news! @CMSGov announced new medical residency positions as a result of recent legislation to #ExpandGME. 135 hospitals across 37 states received at least a portion of a slot. This will improve access to care by expanding the physician workforce. aamc.org/news/press-rel…

@AhmadRehanKhan @TheNRMP @donnalamb_chi In 1953, when the match was established positions outnumbered applicants? Is that the same now?

𝗡𝗥𝗠𝗣 𝗥𝗲𝘀𝗽𝗼𝗻𝗱𝘀 𝘁𝗼 𝗖𝗼𝗻𝗴𝗿𝗲𝘀𝘀𝗶𝗼𝗻𝗮𝗹 𝗦𝗰𝗿𝘂𝘁𝗶𝗻𝘆: @TheNRMP President and CEO @donnalamb_chi released a letter addressing a Congressional inquiry questioning the residency Match system. ✨ The Match was created in 1953 to stop coercive and chaotic hiring and to ensure fairness for both applicants and programs. ✨NRMP does NOT control – Number of residency positions – Resident salaries or contracts – Accreditation standards – Interview or application volume ✨The Match simply pairs applicants and programs based on mutual preference using a transparent algorithm. ✨Claims that NRMP is a monopoly or suppresses wages are misleading and inaccurate. ✨The Matching Algorithm antitrust exemption is narrow and essential to protect fairness and prevent exploitation of trainees. ✨Repealing the exemption would not fix physician shortages or resident pay and could actually worsen recruitment inefficiencies. ✨In 2025, the Match filled 99 percent of available residency positions, showing the system is functioning effectively. ✨NRMP urges the medical education community to engage Congress and correct misconceptions that could destabilize GME. Bottom Line: The Match protects applicants, promotes fairness, and ensures an orderly physician workforce pipeline. Weakening it risks chaos, not reform. ​Read the full statement here: nrmp.org/wp-content/upl… nrmp.org/about/news/202… #NRMP #Match2026 #MedTwitter

@AhmadRehanKhan The Match rate

@UnmatchedMD Numbers to back up what?

I don’t think you fully understand how the Match process or the U.S. healthcare system actually work. For your information, the Match rate for U.S. medical graduates, including both MDs and DOs, is around 93%. The remaining 7% who don’t match are usually those applying to highly competitive specialties that most IMGs don’t even pursue. My post, however, was about post-residency attending jobs, the positions that IMGs take after completing their U.S. residency training, often in remote and underserved areas where very few U.S. graduates choose to work.

Things are very active in my lawsuit against the AMA. They had the court issue a protective order so I cannot discuss what we have found in the discovery process. Hopefully, this information will all be public someday soon. The public deserves to know what really happened at JAMA and the AMA in 2021. It says a great deal about the integrity of these organizations and the people who worked in them. In reviewing publicly available documents, I remain baffled by all those who said I "did not get it." That the podcast denied the existence of racism in medicine. That the podcast was racist. That I am a bigot, racist and White supremacist. Here is an excerpt: (static1.squarespace.com/static/5d7d985…) Ed Livingston (11:31): So asking you a hard question: What do we do to end structural racism or try to address it the best we can? Closing on Structural Racism's Implications (11:39–End)Mitch Katz (11:39): We acknowledge that it exists. So and again, that's why I make the distinction. Acknowledging structural racism does not mean saying that I'm a racist. It means saying that our country's policies need to be changed. And then I think your, your next part would be to say, Okay, well, what would the US look like, if we didn't have structural racism? What it would look like is that we might still have people living in poverty, but they wouldn't be disproportionately minority. We would still have people in jail, but they wouldn't be disproportionately minority. We would still have people who lived in substandard housing, but they wouldn't be disproportionately from the minority. We would at every level, you would see all of the country in an equitable way, so that the proportion of doctors and lawyers and senators and Supreme Court Justices would reflect the percentages in the population because we don't believe that it's genetic differences, right. We don't believe that the disproportionate harm that's come to African Americans and Latinos for their health is because of genetic differences. We're physicians. And we know there are a few diseases, you know, whether that's sickle cell or Tay Sachs, that have a genetic basis. But that is not why we believe that Black and Brown people have higher mortality in this country due to COVID and a number of other illnesses. So the world that doesn't have structural racism is a world where everyone doesn't grow up to be President, but anyone could grow up to be President. So, in contrast to what JAMA, the AMA and social media said-that I denied the existence of racism in medicine, I actually asked how to end structural racism. If I thought it did not exist, why would I ask how to end it? Why was @DrAlethaMaybank outraged by my asking how to end structual racism? Katz explicitly says structural racism exists, despite the widespread claim that the podcast denied the existence of racism in medicine What is important here is the damaging effects of DEI initiatives as they existed in 2021. People were quick to cancel others as occurred to me. I was forced out of my job (no, I did not voluntarily resign-I was told I was going to be fired and, to this day, never told why and the AMA has yet to provide any explanation regarding why they did this to me). I was never allowed to tell my side of the story or explain what was actually in the podcast rather than what people claimed was in it. Read the exerpt-How do you go from what was actually in the podcast to saying it denied the existence of racism in medicine. I bring this up because the JAMA tweet/podcast affair needs careful examination by the academic community. In the name of health equity, people launched a campaign based on misinformation that stifled discussion about the health of minorities. This was about political posturing. The hysteria about the podcast had nothing to do about bettering the health of minorities. In fact, it moved the needle in the wrong direction. We, in academics, need to study what happened here and never let this happen again.

🚨 18 states now allow #IMGs — who completed residency abroad and hold a foreign medical license — to obtain a full, unrestricted U.S. medical license without residency or entering the Match. 🚫 Not the same as the 15 limited licenses for #unmatched graduates (Assistant, House, or Bridge). These don’t convert to full licensure, and the experience isn’t credited. #Unmatched graduates must still re-enter the Match. #unmatchedMD

Update: Global Azure Outage impacting Thalamus is still being mitigated. Microsoft has announced they are working to restore systems with safeguards in place. We are continuing to monitor and will provide updates as they become available.

Will the $100K H-1B fee affect Match applicants? H-1B visas require a full, unrestricted license to practice independently on day one. But residency runs under a supervised training license. Is this a loophole, or are Match applicants not affected? #Match2026 #H1B #IMG #Residency #MedTwitter #unmatchedMD

🚨 Psychiatry PGY-2 to PGY-4 Openings The Dept. of Psychiatry at Texas Tech El Paso (Transmountain Campus) has 4 open positions to start before June 2026. 📧 Send CV + rotation list to PC Jessica Arocha (jesaroch@ttuhsc.edu) 🗓️ Apply by Oct 15 #PsychiatryResidency #Residency #Psychiatry #ResidencyOpportunities #MedTwitter #UnmatchedMD

I ❤️ ResidencyCAS so much. I have gone so far into the weeds of customization it’s insane. On my curved widescreen gaming monitor, the amount of app info I can quickly see when sorting people is awesome.

@ThalamusGME Can you share the link please?

@UnmatchedMD It provides grants for all costs of applying to residency, match costs, away rotations, technology, conferences, professional dress and more.

1/ With respect, here’s what’s being missed about early interview invites this year: It’s about timing, not the total number of invites. This year, all applicants—including IMGs—are getting interviews within 3 days of ERAS opening. That’s never been the norm.

@ThalamusGME Is it the one that was giving scholarships for ERAS fees?

@UnmatchedMD Yes, the process is too expensive (one of the reasons we were founded). Also, it's one of the reasons we founded a sibling, non-profit too: thalamus.org & now we're back at the start, of how we are building tools for applicants to apply more efficiently for less $.

@ThalamusGME You don’t charge applicants directly, they pay in other ways

@UnmatchedMD Also, is this a conflict of interest? unmatchedmd.com/priceplans/ Seems like you're making money off of applicants. Thalamus doesn't charge applicants anything.

Back when Dr. Carmody was advocating for application caps and I was advocating for unmatched MDs, Dr. Reminick approached us for insights & collaboration on his #GMEBillofRights initiative gmeequality.com The site eventually went offline—but I’m guessing that’s what prompted this blog post thalamusgme.com/blogs/thalamus…

@UnmatchedMD And this is what Cortex was built to do, again, recommend all interested read: thalamusgme.com/blogs/artifici… Our founder was a former applicant and the main reason Thalamus was founded was to make this process easier for applicants. We've made progress, but always more work to do.

Cortex uses artificial intelligence & machine learning (AI/ML) tools—like natural language processing (NLP) & optical character recognition (OCR)—to aggregate key application data. It cuts screening time by ~50%, giving programs a faster, tech-assisted holistic review without reading 8,000 apps manually.

@UnmatchedMD Per the above and here, Cortex wasn't designed to "speed things up." It was designed to aggregate and provide context in data, so that programs could more efficiently provide a full holistic review, rather than scavenger hunts trying to find data embedded in the application

@ThalamusGME The NRMP changed its policies last year so it’s not required to investigate an alleged violation.

@UnmatchedMD Chart shown is from 2020. Thalamus published (2019) that programs were inviting more than # of positions, and has been actively working to diminish this behavior. NRMP made this a match violation few years back, and now this program behavior has all but stopped, which is big +

Agreed—hard to gauge competitiveness when applicants don’t even know how many positions a program has. Now they also won’t know if AI was used to screen their application—doesn’t that make things even less transparent? And isn’t the Nobel Prize–winning Match algorithm supposed to handle the pairing?

@UnmatchedMD The broader challenge is applicants and programs have limited insight into who is competitive where and who is considering where, including as you note the number of PGY positions available. This is the problem we want to solve, through data to better pair applicants/programs.