Demographic Differences Between Applicants Who Submitted Rank Order Lists and Applicants Who Matched in 2022 and 2023.

Resident selection processes may alter the representation of applicants with certain demographic characteristics. The impact of potential biases at each phase of selection should be examined. To investigate the differences between applicants who submit rank order lists (ROLs) and applicants who match in the National Resident Matching Program (NRMP) Main Residency Match. We analyzed publicly available NRMP data for the 2022 and 2023 Matches to compare self-reported sex, sexual orientation, race, ethnicity, disability status, and citizenship between applicants who submitted ROLs and applicants who matched. Of the 73 426 applicants who submitted ROLs, 60 655 applicants matched. A higher percentage of matched applicants were female as compared to those who submitted ROLs (+2.0%, 95% CI, 1.4 to 2.5). A higher percentage of matched applicants identified as bisexual (+0.2%, 95% CI, 0.04 to 0.4), whereas a lower percentage of matched applicants identified as heterosexual (-0.4%, 95% CI, -0.7 to -0.1). White applicants represented a higher percentage of matched applicants (+2.9%, 95% CI, 2.3 to 3.4), whereas Asian and Black/African American applicants comprised lower percentages of matched applicants as compared to all applicants (Asian: -1.5%, 95% CI, -2 to -1; Black/African American: -0.6%, 95% CI, -1 to -0.3). Hispanic/Latino and non-US citizens also comprised lower percentages of matched applicants (Hispanic/Latino: -0.5%, 95% CI, -0.8 to -0.1; non-US citizen: -4.9%, 95% CI, -5.3 to -4.5). There was no difference for applicants with disabilities. Differences exist between the demographics of applicants who submitted ROLs compared to those who matched.