ID Match 2017: Turning point or artifact of "all in" approach?

The dust is still settling from this year’s ID Match, but at first glance it looks like a much-needed step in the right direction. Compared with last year, the number of unfilled positions (on match day, that is, which doesn’t count positions that will be filled after the match) is down to 80 from 117, and the number of unfilled programs is down to 54 from 82. This is not to minimize the pain for programs that didn’t match—>50 is still way too many, and comparable to the number of unfilled programs in 2014.

This dramatic shift from the trend of the last three years must be due in part to the “all-in” strategy that IDSA is pursuing (requiring that all ACGME positions be offered in the match, trying to minimize those positions offered before or after). The question is how much of this shift reflects an absolute increase in the number of trainees after the post-match numbers are included. For example, there is still the chance that interested individuals opt out of the match, hoping to snag a good position afterwards (obviating the expense, time and anxiety the interview circuit). 

The challenges to attracting the next generation of ID physicians remain daunting, and this one-year change in match results (temporally associated with a new “all in” policy) shouldn’t detract from the urgency of these efforts. We’ll have a much better sense of how we are doing (at least from the training program side) after another 1-2 years of the “all in” match. If programs and applicants continue to adhere to the "all in" approach (i.e. how will it be enforced?), at least it should give us a more accurate assessment of the supply-demand situation.

I’d welcome input from other program directors, IDSA leadership, and anyone else with thoughts on this year’s match results!