What Specialties Had Unfilled Positions in the 2025 Residency Match?
In short: There were 2,473 unfilled residency positions in the 2025 Match (before SOAP), with a handful of specialties contributing the bulk. Family Medicine — again — led the field. But several competitive fields saw tiny gaps too. Let’s break down what’s happening, and why this matters for next-cycle applicants.
📊 Overall Snapshot & Context
In 2025, 43,237 positions were offered, of which 40,041 were PGY-1 slots.
After the matching algorithm (before SOAP), 40,764 positions were filled, leaving 2,473 unfilled.
With SOAP cleanup, the final fill rate (Match + SOAP) was 99.4 % of available positions.
The unfilled count (2,473) decreased by 89 from 2024 (i.e., fewer unfilled slots year over year).
So while “unfilled slots” still exist, they’re becoming rarer — but their distribution is not uniform across specialties.
🏥 Which Specialties Had Notable Unfilled Positions?
Here is a specialty-by-specialty summary of fields with unfilled slots, (These are real numbers derived from the NRMP tables.)
A few additional observations:
Orthopedic Surgery and Plastic Surgery had zero unfilled slots.
Internal Medicine had 357 unfilled slots, though the fill rate was still high (96.8 %).
Obstetrics‒Gynecology (OB/GYN) had 10 unfilled spots total (1 categorical + 9 preliminary).
🔍 Why Do Some Specialties Leave Spots Unfilled?
1.
Expansion of positions / overshoot vs interest
Some fields, particularly primary care (family medicine, internal medicine, pediatrics), keep expanding their positions to address workforce shortages. If applicant interest doesn’t scale proportionally, gaps appear.
Family Medicine added 144 slots this year but filled only 85 % — leading to 805 vacancies.
Internal Medicine expanded significantly: 11,750 positions offered, 11,379 matched, fill rate 96.8%.
2.
Perceived prestige, compensation, lifestyle tradeoffs
Many applicants avoid fields seen as less “glamorous” or financially rewarding, even when those fields deeply need providers (e.g. family medicine).
3.
Mismatch between applicant pool and specialty demands
Certain specialties require very high academic metrics, research experience, or strong clinical exposure. If the applicant pool doesn’t match, programs may leave positions unfilled.
4.
Geographic / program location deterrents
Positions in less desirable locations are more likely to be unfilled, especially in rural or underserved areas.
5.
SOAP and last-minute bidding dynamics
Some unfilled positions are “rescued” by SOAP, but not all. Most specialties with unfilled slots rely heavily on SOAP to close gaps.
🎯 Strategic Takeaways for Applicants (Especially IMGs & Late Deciders)
If you’re flexible, target specialties with gaps (family medicine, internal medicine) — you may find more opportunity and less barrier.
Don’t auto-skip primary care: the “competition advantage” can sometimes favor those willing to commit.
Quality still matters: Just because a specialty has unfilled slots doesn’t mean credentials don’t matter. Programs will still pick the best candidates.
Leverage SOAP wisely: Many of these unfilled positions move into SOAP—be strategic in eligibility and application timing.
Geography is a factor: Be willing to go off the beaten path (rural, underserved) to gain access to slots that urban programs reject.
