2025 Residency Match Statistics & Strategy for Osteopathic Applicants
Quick Summary (TL;DR): The 2025 NRMP® Match was the largest on record and delivered a 92.6 % match rate for U.S. DO seniors—the best to date. This article breaks down key statistics, specialty competitiveness, SOAP outcomes, and a step‑by‑step game plan to help osteopathic applicants crush the 2026 Match.
Why This Year’s Match Matters
The Main Residency Match is the single biggest career inflection point for medical graduates, and 2025 shattered every prior record. With 52,498 registered applicants competing for 43,237 residency positions (40,041 PGY‑1), this cycle saw a 5 % increase in applicants and a 3 % rise in total positions compared with 2024. Those raw numbers hide important nuances:
U.S. medical school expansion continues, but position growth is being driven largely by community‑based GME consortia, not traditional academic centers.
USMLE Step 1 shifted to pass/fail in 2022; 2025 is the first class to have fully pass/fail pre‑clinical transcripts, forcing program directors to re‑weight other metrics such as Step 2 CK and clerkship performance.
Osteopathic Recognition programs jumped from 327 to 356, giving DO applicants more opportunities to highlight osteopathic manipulative medicine (OMM) skills.
DO students not only competed head‑to‑head with MD peers—they excelled, posting the highest match rate on record while diversifying into more competitive specialties.
Headline Numbers at a Glance
| Applicant Group | Registered | Active* | PGY‑1 Matched | PGY‑1 Match Rate | Overall Placement Rate |
|---|---|---|---|---|---|
| U.S. MD seniors | 20,365 | 19,986 | 18,684 | 93.5 % | 97.8 % |
| U.S. DO seniors | 8,400 | 8,397 | 7,773 | 92.6 % | 98.4 % |
| U.S. IMGs | 6,515 | 6,201 | 4,209 | 67.8 % | 73.5 % |
| Non‑U.S. IMGs | 12,467 | 11,908 | 6,901 | 58.0 % | 60.3 % |
| All applicants | 52,498 | 50,492 | 37,667 | 79.8 % | 84.2 % |
*Active = certified rank list submitted
Historical Trends: DO Momentum Since 2021
| Year | DO Match Rate | Δ vs prior year |
| 2021 | 89.1 % | – |
| 2022 | 89.9 % | ▲ 0.8 % |
| 2023 | 90.9 % | ▲ 1.0 % |
| 2024 | 92.3 % | ▲ 1.4 % |
| 2025 | 92.6 % | ▲ 0.3 % |
Four straight years of gains illustrate a structural shift rather than a fluke. Several factors fuel this momentum:
Growth of community hospital programs that value the holistic, primary‑care‑oriented skillset common in osteopathic curricula.
Expanded Osteopathic Recognition requirements in family medicine, internal medicine, and PM&R, guaranteeing faculty capable of supervising OMM.
Strategic advising—organizations like the AACOM/EFDO “Apply Smart” initiative push data‑driven application strategies and discourage costly over‑application.
Specialty Breakdown: Where DOs Matched & Where They Shined
Top 10 Specialties for DO Seniors (PGY‑1 matches)
Internal Medicine – 2,067
Family Medicine – 1,482
Emergency Medicine – 1,078
Pediatrics – 645
Psychiatry – 542
Transitional Year – 346
General Surgery – 325
Obstetrics & Gynecology – 315
Anesthesiology – 308
Neurology – 154
Fastest‑Growing DO Presence (2024 → 2025 change)
| Specialty | 2024 DO Matches | 2025 DO Matches | % Growth |
| Orthopaedic Surgery | 99 | 131 | +32 % |
| Anesthesiology | 258 | 308 | +19 % |
| Psychiatry | 472 | 542 | +15 % |
| General Surgery | 287 | 325 | +13 % |
| PM&R | 202 | 228 | +13 % |
Even traditionally competitive fields—orthopaedics and anesthesiology—are opening doors to strong DO candidates who couple solid Step 2 CK scores (> 250) with robust research and away rotations.
The SOAP Safety Net: How It Works & Who Benefited
SOAP (Supplemental Offer and Acceptance Program) provides unmatched applicants up to four rounds of position offers during Match Week. In 2025:
2,521 positions entered SOAP (≈ 6 % of all slots).
2,318 positions were filled by Thursday afternoon—a 99.4 % overall fill rate.
45 % of SOAP offers went to U.S. citizens (MD + DO), with DO seniors accepting 612 spots.
Pro tip: Applicants who created SOAP‑ready personal statements and updated ERAS documents before Match Week quadrupled their odds of landing a position versus those scrambling on Monday.
Common SOAP‑participating specialties include Preliminary Surgery, Internal Medicine – Prelim, Transitional Year, Family Medicine, and Pediatrics. Planning parallel pathways in these fields is crucial if you apply to ultra‑competitive specialties.
Application Inflation & Interview Dynamics
The average U.S. DO senior submitted 78 applications (down from 84 in 2024) yet received a nearly identical number of interview offers (mean = 15). Two forces contained the arms race:
Interview caps: Many programs limited virtual invites to 30 % above capacity, reducing hoarding.
Preference signaling: ERAS tokens allowed applicants to “signal” up to five programs; 71 % of DO interview invitations came from a signaled program.
Still, the cost burden was steep—median spend on ERAS fees and travel topped $4,200.
Competitiveness Index: DO vs MD vs IMG by Specialty
Below is a distilled competitiveness index (CI) that blends fill rate, Step 2 CK mean ± SD, research output, and interview‑to‑match ratios. A higher CI means tougher odds.
| Specialty | CI Score (1–10) | DO Share of 2025 Matched Residents |
| Dermatology | 9.4 | 5 % |
| Orthopaedic Surgery | 9.0 | 7 % |
| ENT | 8.8 | 4 % |
| Anesthesiology | 7.5 | 17 % |
| PM&R | 6.8 | 37.5 % |
| Family Medicine | 4.2 | 31 % |
| Internal Medicine | 4.0 | 18 % |
| Psychiatry | 3.9 | 22 % |
| Transitional Year | 2.1 | 35 % |
Use this table to calibrate risk: pairing a CI ≥ 8 specialty with one CI 4–6 backup and a CI ≤ 3 safety markedly lowers the likelihood of going unmatched.
What Program Directors Said
Each February, NRMP surveys program directors about selection criteria. Highlights from the 2025 PD Survey (n = 1,873):
Step 2 CK score ranked #1 for interview offers by 72 % of PDs; mean cutoff among responding programs was 229.
Class rank/clerkship grades jumped to #2 after the demise of Step 1 numeric scores.
COMLEX‑USA Level 1 & 2 were accepted at face value by 63 % of allopathic programs—up from 48 % in 2021—though many still require USMLE.
Holistic fit (personal statement + letters + non‑academic attributes) entered the top five for the first time.
Take‑home: strong academic metrics remain essential, but narrative elements now have unprecedented sway.
Action Plan for 2026 Applicants
1. Build a Data‑Driven Program List
Aim for ≥ 12 programs in your primary specialty plus 3–5 backups.
Mix programs across competitiveness tiers using the CI table above.
2. Prioritize Step 2 CK
Schedule CK no later than 15 September; scores ≥ 245 improve DO odds across the board.
3. Signal Smartly
Use ERAS preference signals on programs where you have a geographic or mission‑fit story.
4. Craft a Parallel SOAP Packet
Write a SOAP‑specific statement and update CV/LoRs by January 15.
5. Leverage Your Osteopathic Identity
Highlight OMM training and holistic philosophy, especially for primary‑care‑leaning programs.
6. Budget Early
Apply for AACOM’s financial assistance, set interview travel ceilings, and consider virtual second‑looks rather than expensive in‑person visits.
Final Thoughts
The 2025 Match tells a story of growth—both in GME slots and in the confidence programs place in osteopathic physicians. With a 92.6 % match rate and near‑universal placement after SOAP, DO seniors proved that strategic preparation and a patient‑centered skillset translate into success. Yet rising applicant numbers and shifting evaluation metrics mean complacency is not an option.
As you gear up for the 2026 cycle, anchor your strategy in data, stay adaptable, and remember that OMM’s holistic roots remain an enduring competitive edge. Remedy OMM will be by your side with evidence‑based advice, interview workshops, and a community of peers who have walked the same path.
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