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!


  1. It's good but unsurprisingly that the "all in" approach increased the number (and likely proportion) of slots filled in the Match. Giving antibiotics sometimes lowers the white count.

    The problem still remains. The patient is still bacteremic. Lots of slots are unfilled, and surveys suggest the major reason is that our smart applicants struggle to rationalize 2-3 more years of training in order to make less than they could right away as a hospitalist.

    Is there a way to fix this compensation mismatch through negotiation alone, or does the solution require worsened inadequacy of staffing and the associated harms to patients? This is a good example of how the forces of supply and demand, powerful and necessary though they are, do not fix all problems. The customer doesn't know that at certain times they're more likely to die if they don't pick this particular item off the shelf.


  2. With all-in applicants will not be able to "cherry pick," as most of the powerhouse and big name programs this year filled all of their spots, thus this theory would not work. All-in is a step in the right direction and further reform is needed moving forward. Congrats to all those who matched!


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