1822 - Comparative Application and Match Trends Among IMGs, US MDs, and US DOs in Physical Medicine & Rehabilitation (2013–2025)

Physical Medicine and Rehabilitation (PM&R) is a growing specialty critical for restoring mobility and improving quality of life of patients. Residency match outcomes shape the future of the PM&R workforce. While the numbers for U.S. MD and DO applicants have steadily increased, the representation of International Medical Graduates (IMGs) within the field has declined. With the growing demand for PM&R physicians, examining application and match trends over time is essential for understanding barriers.

Design: Residency application data (2013–2025) were obtained from the AAMC FACTS Table on Residency Applicants by Specialty and Medical School Type, including IMG, US MD, and US DO applications to PM&R and all specialties, with Pediatrics/PM&R combined into PM&R. Match data were sourced from NRMP archives. Expected matches were calculated by applying the proportion of applicants in each group to total PM&R positions. Chi-square analysis with contributions and residuals was performed in Excel to compare actual versus expected matches.

Results: From 2013 to 2025, PM&R applicants have increased overall with the growth driven by US-MDs and DO candidates. However, despite steady interests, IMG applications have not only steadily declined but consistently fallen below expected rates. When adjusted for application volume, US-MDs and DOs have matched proportionally but IMGs show a widened gap. Limited visa sponsorship, observership and clerkship opportunities, lack of knowledge for the field, many residency programs being non-IMG friendly are some factors that contribute to the notable discrepancy between the proportion who apply and those who successfully match.

Conclusions:

The future of physiatry hinges on the trainees who enter the field, especially as America’s aging and diverse population drives an increasing demand for more physiatrists. Declining IMG representation threatens this through the loss of valuable talent and perspectives for the field. Expanding pathways for IMGs is essential to meet rising demand and ensure equitable access to physiatric care.