Association of American Medical Colleges, Washington, DC 20037-1127, USA.
Acad Med. 2012 May;87(5):586-91. doi: 10.1097/ACM.0b013e31824d48e4.
Analysts who assess trends in medical specialty choice often use statistics published by the National Resident Matching Program (NRMP), but a substantial minority of new residents find their positions outside of the NRMP. Rule changes to be implemented by the NRMP in 2013 may have a substantial impact on this behavior.The author quantified and characterized residents who found their positions outside of the NRMP. Using available data, the author was able to distinguish those who were unsuccessful in the NRMP from those who did not register and those who registered but failed to enter a rank order list of preferred programs.
NRMP data on applicants in 2009 (n = 36,971) were combined with data from the national resident census contained in the GMETrack system on residents who began their graduate medical education in 2009-2010 (n = 25,432). Residents were classified into categories based on their participation in the NRMP and their success in matching to a position, and by the type of medical school from which they graduated.
Applicants who matched in the NRMP were 79.8% of new residents in first-year residency positions (n = 20,287). An additional 5.2% (n = 1,325) participated in the NRMP but were unsuccessful in matching. Aside from a small number of military residents, the remaining 13.7% (n = 3,488) found positions without participating in the NRMP Match.
Workforce studies that rely on NRMP statistics alone to establish national trends are seriously deficient.
评估医学专业选择趋势的分析人员通常使用国家住院医师匹配项目（NRMP）公布的统计数据，但相当一部分新住院医师的职位不在 NRMP 范围内。NRMP 将于 2013 年实施的规则变更可能会对这种行为产生重大影响。作者对在 NRMP 之外找到职位的住院医师进行了量化和特征描述。作者利用可用数据，能够区分那些在 NRMP 中不成功的人与那些没有注册的人和那些注册但未能进入首选计划排名列表的人。
将 2009 年申请人的 NRMP 数据（n=36971）与 GMETrack 系统中包含的 2009-2010 年开始研究生医学教育的住院医师全国居民普查数据（n=25432）相结合。根据他们在 NRMP 中的参与情况以及与职位匹配的成功情况以及他们毕业的医学院类型，将住院医师分为不同类别。
在 NRMP 中匹配的申请人占第一年住院医师职位的新住院医师的 79.8%（n=20287）。另外 5.2%（n=1325）参加了 NRMP，但未能匹配。除了少数军事住院医师外，其余 13.7%（n=3488）在没有参加 NRMP 匹配的情况下找到了职位。
仅依靠 NRMP 统计数据来确定国家趋势的劳动力研究存在严重缺陷。
