The 2026 Match was the biggest ever, but there were some soft spots in primary care and a drop in the number of applicants who needed visa sponsorships that may point to bigger problems in the future.
First, the good news: The 2026 Match offered 1,107 more positions than last year—412 of them in primary care alone—for a total of 44,344 positions. That’s a 2.6% increase in positions offered in 2025.
There were also 842, or 1.8%, more applicants in this year’s Match: 53,373. Of those, 38,354 matched to a PGY-1 position. A total of 41,482 applicants matched to a PGY-1 or PGY-2 position.
Match trends by citizenship status
More than 93% of positions were filled in the Match, with fill rates for U.S. citizens growing or holding the line from previous years. But 2026 Match data may also point to a looming problem with non-U.S. citizens applying for training slots in the U.S.:
- 5% of U.S. MD seniors matched, the same as in 2024 and 2025.
- 2% of U.S. DO seniors matched, a 0.6% increase from 2025.
- 70% of S. citizen IMGs matched, up 2.2% from 2025.
- 4% of non-U.S. citizen IMGs matched, down 1.6% from 2025.
The drop in fill rates among non-U.S. citizen IMGs was significant enough that the National Resident Matching Program (NRMP) examined differences between applicants who did and who didn’t need visa sponsorship. A press release noted that applicants who needed visa sponsorship had a 54.4% match rate among PGY-1s. Non-U.S. citizen IMGs with permanent legal residence (usually a green card), by comparison, had a 67.9% match rate among PGY-1s.
The match rate for green card holders was a new high for the Match, but the rate for applicants who needed visa help was nearly five points lower than the highest rate, which was seen in 2023. A statement from the NRMP said that recent changes in immigration policy “have increased attention to visa sponsorship considerations in residency recruitment for foreign-born candidates.”
This year’s data, the organization said, may be highlighting how “broader policy conditions could shape future Match outcomes for non-U.S. citizen IMG candidates.” That could mean changes in how training programs recruit noncitizen trainees in the future, the statement added, which could have dramatic impacts on the physician workforce.
Analysts in a MedPage Today article predicted that the drop in fill rates for applicants who need visa help may only accelerate in coming years. They noted that plans for visa sponsorships are made years in advance, so the impact of the Trump administration’s $100,000 filing fee for H-1B visas, which went into effect relatively recently, may be felt more strongly in coming years.
Those analysts also said that uncertainty or problems navigating the visa process could cause some residency program directors to back away from matching non-citizen candidates if they think visa rules may leave their programs understaffed.
Specialty performance in the Match
In primary care, the 2026 Match offered 20,712 primary care slots. This year’s fill rate was 92.1%, which is a 1.4% drop from 2025.
- Internal medicine added 280 more slots for 2026. The fill rate was 95.2%, a 1.6% drop from 2025.
- While pediatrics offered eight fewer slots this year, its fill rate of 94.4% was still down 0.9% from last year.
- Family medicine added 134 more slots, but its fill rate was 83.6%, down from 85% in 2025. That left 899 positions unfilled.
Family medicine matches dropped for the second year in a row in 2026, which got the attention of Match officials. The NRMP said that it plans to convene a “blue-ribbon panel” of family medicine leaders and stakeholders this year to examine factors in the specialty’s growth and sustainability.
- Emergency medicine offered 130 more positions this year for a total of 3,198 positions. While its fill rate of 95.6% was 2.3% lower than 2025, the specialty saw a 1.8% increase in matched applicants. The good news is that the specialty has largely recovered from two rough years in the Match in 2022 and 2023.
- Psychiatry offered 128 additional positions from 30 new training programs in 2026 and ended up filling 71 more positions than in 2025. That gave the specialty a total fill rate of 97.4% or 2,451 filled positions. While psychiatry has seen a steady uptick in match rates among US. DO seniors and non-US IMGs over the last five years, Match rates among US MD seniors have fluctuated.
