Report on Residents

Executive Summary

December 2020

Report on Residents

Executive Summary

Background

The AAMC Report on Residents is an online collection of data tables that includes current and historical data

related to graduate medical education (GME). These tables provide information about characteristics of residency

applicants and residents and about post-residency professional activities. This report will help residency applicants,

residency program directors, and researchers understand the changing body of residents and fellows at a critical

time in their medical training. The AAMC wishes to acknowledge the American Association of Colleges of

Osteopathic Medicine (AACOM), American Medical Association (AMA), American Osteopathic Association,

Educational Commission for Foreign Medical Graduates, National Board of Medical Examiners (NBME), and

National Board of Osteopathic Medical Examiners (NBOME) for helping make these analyses possible.

Methodology

This publication complements existing data reports that address different aspects of GME. It incorporates multiple

sources of information when possible, using the wide range of data available to the AAMC and described in

Table 1.

In each data table, the year or years of data included represent the most recent data available. The specific years of

data, and the data sources used, are identified for each table either as part of the table or in the notes.

The report’s data sources have different participation rates, which vary across years. Approximate participation

rates for each data source, when available, are provided in Table 1. Because many of the report’s tables combine

data from different data sources, the number of individuals in a given report is limited to those for whom we have

data for all relevant variables. Counts of individuals are included in all the report’s tables.

The Report on Residents is organized in chronological order of progression through GME: pre-residency,

residency, and post-residency. Some tables display data by specialties and subspecialties accredited by the

Accreditation Council for Graduate Medical Education (ACGME). According to the ACGME, a specialty program

is a “structured educational experience in a field of medical practice following completion of medical school and,

in some cases, prerequisite basic clinical education designed to conform to the Program Requirements of a

particular specialty.”

The prerequisite specialties include programs that serve as preliminary training for residents

who intend to subspecialize. A subspecialty program is a “structured educational experience following completion

of a prerequisite specialty program in graduate medical education designed to conform to the Program

Requirements of a particular subspecialty area.”

The specialty identified as “Transitional Year” includes programs

that provide training in multiple disciplines to help residents prepare for selecting and entering a specialty.

Tables displaying data on first-year residents may include residents who later enter another specialty or

subspecialty. This mostly affects specialties such as General Surgery, Internal Medicine, and Pediatrics, in which a

one-year experience may be required before the resident trains in another specialty. Also, a large percentage of

those completing residencies in these three specialties go on to complete subspecialties within those specialties.

For data displays that include people who have completed their residencies (“completed residents”) or practicing

physicians by specialty, the most recently completed GME specialty or subspecialty is shown. Residents who

completed training in a specialty but are active in another GME program are excluded from the counts of

completed residents or practicing physicians, unless otherwise noted.

Report on Residents

Executive Summary

Table 1. Data Sources Available to the AAMC

Data Source

Description

Annual Osteopathic Medical

School Questionnaire

This questionnaire is completed by DO-granting medical colleges and

collects information on the number of DO graduates in a given year. It is

administered by the American Association of Colleges of Osteopathic

Medicine.

Comprehensive Osteopathic

Medical Licensing

Examination of the United

States (COMLEX-USA)

The COMLEX-USA is a three-level, national, standardized examination for

licensure for the practice of osteopathic medicine created by the National

Board of Osteopathic Medical Examiners.

Faculty Roster

The AAMC initiated the Faculty Roster in 1966 to support national policy

studies by collecting comprehensive information about the characteristics of

paid faculty members at U.S. medical schools accredited by the Liaison

Committee on Medical Education (LCME

). The Faculty Roster typically

has a response rate of almost 100% (e.g., 99.4% in fiscal year 2019).

GME Track

Resident

Survey (GME Track)

GME Track is a resident database and tracking system introduced in March

2000 by the AAMC and the American Medical Association (AMA) to help

GME administrators and program directors collect and manage GME data.

The GME Track Resident Survey typically has a response rate of about

94% (e.g., 94.1% in 2019). GME Track resident status information is

collected as of Dec. 31 of the corresponding year. For example, the 2019

GME year represents residents who were active in training as of Dec. 31,

2019.

Matriculating Student

Questionnaire (MSQ)

The AAMC MSQ is an annual questionnaire administered since 1987 to all

first-year medical students at LCME-accredited U.S. medical schools. The

MSQ typically has a response rate between 65% and 72% (e.g., 71.2% in

2019).

Medical School Graduation

Questionnaire (GQ)

The AAMC GQ is an annual questionnaire administered since 1978 to all

students graduating from LCME-accredited U.S. medical schools. The GQ

typically has a response rate of about 82% (e.g., 81.6% in 2020).

Physician Masterfile (AMA

Masterfile)

Established by the AMA in 1906, the Physician Masterfile includes

education, training, and professional certification information. It contains

current and historical data for more than 1.4 million physicians, residents,

and medical students in the United States. Data for physicians not

represented in the AMA Physician Masterfile may be missing from the

report. For example, about 5% of completed residents in GME Track are

not represented as active physicians in the AMA Physician Masterfile. As a

Report on Residents

Executive Summary

result, practicing physicians may be underrepresented. AMA physician

status information is reported as of Dec. 31 of the corresponding year. For

the 2020 Report on Residents, AMA Physician Masterfile data represent

physician statuses as of Dec. 31, 2019.

Student Records System

(SRS)

The AAMC SRS houses secure, centralized enrollment information about

the national medical student population and tracks student progress from

matriculation through graduation. All LCME-accredited U.S. medical

schools verify 100% of medical students in the SRS.

United States Medical

Licensing Examination

(USMLE)

The USMLE is a three-step exam for medical licensure in the United States

sponsored by the Federation of State Medical Boards (FSMB) and the

National Board of Medical Examiners (NBME).

Selected Findings

The Report on Residents examines unique trends among states, specialties, and phases of the GME continuum. The

tables and the selected findings below are organized by progression through GME to reflect the different ways that

people use the data. For example, current medical students looking to apply to residency programs may be

interested in the test scores and experiences of first-year residents in various specialties. Alternatively, state policy

analysts focusing on workforce or funding issues may be concerned with retaining physicians who completed

residency training in a particular state.

Pre-residency

• Over the course of medical school, most medical students change their preferred residency specialty. For

the past three years, between 25% and 27% (26.1% in 2020) of respondents to the GQ indicated the same

specialty preference as they had on the MSQ (Table A1).

• Specialty preference continuity in Orthopaedic Surgery increased from 44.8% in the 2019 Report on

Residents to 48.7% in 2020. Orthopaedic Surgery continues to have the highest rate of specialty preference

continuity from medical school matriculation to medical school graduation (Table A1).

• On average, first-year residents in Obstetrics and Gynecology reported participating in the highest average

number of volunteer experiences (9.0) (Table B1).

Residency

• While the overall number of residents was higher in 2019 than in 2018, the percentage of residents who are

international medical school graduates has decreased each year, from 25.9% in the 2015 Report on

Residents to 23.1% in the 2020 Report on Residents (Table B3).

• In 2019, 3.3% of all active residents who are graduates of U.S. MD-granting schools were MD-PhD

graduates (Table B4).

Report on Residents

Executive Summary

• Of general specialties, Pathology: Anatomic and Clinical had the highest percentage of active U.S. MD-

PhD graduates in 2019, at 16.6% (Table B4).

• The distribution of active MD residents by race/ethnicity varies across specialties. Overall, 50.8% of active

U.S.-citizen MD residents in 2019-20 reported White, 21.8% reported Asian, 7.5% reported Hispanic,

5.5% reported Black or African American, 0.6% reported American Indian or Alaska Native, and 0.2%

reported Native Hawaiian or Other Pacific Islander. Additionally, 16.5% of active MD residents were non-

U.S. citizens in 2019-20 (Table B5).

Post-residency

• Overall, 25.5% of the individuals who completed residency from 2010 through 2019 are practicing in

Medically Underserved Areas (MUAs) (Table C2).

• More than half of the individuals who completed residency training from 2010 through 2019 and are

practicing in Alabama are practicing in MUAs (Table C3).

• More than half (55.5%) of the individuals who completed residency training from 2010 through 2019 are

practicing in the state where they did their residency training (Table C4). This retention rate is slightly

higher than the rate for individuals who completed residency training from 2009 to 2018 (54.6%).

• A higher proportion of women who completed residency training from 2010 through 2019 are practicing in

the state of their residency training — 59.1% — than men, at 52.5% (Table C5).

• California has the highest physician retention rate, with 77.6% of individuals who completed residency

training going on to practice in state (Table C6).

• Of those individuals who completed residency training from 2010 through 2019 and hold a full-time

faculty appointment at a U.S. MD-granting school, 77.4% hold appointments at the assistant professor

level (15.3% of the entire cohort of people who completed residency training) (Table C8). This percentage

decreased slightly from the 77.6% of people who completed residency training from 2009 through 2018.

Next Steps

Although the changes in this report from year to year are often marginal, the Report on Residents is one of many

important resources for tracking changes within the largest specialties and subspecialties. Those interested in

exploring data for a research project may request specific data by submitting a copy of the AAMC Data Request

Form. Additional information is available in the ACGME Data Resource Book.

Providing Report Feedback

Comments on how to improve this report are welcome. Please share your thoughts by emailing

residentreport@aamc.org.

Report on Residents

Executive Summary

Reference

1. Accreditation Council for Graduate Medical Education. ACGME Data Resource Book: Academic Year 2019-

2020. Chicago, IL: ACGME; 2020. acgme.org/Portals/0/PFAssets/PublicationsBooks/2019-

2020_ACGME_DATABOOK_DOCUMENT.pdf.