AAFP residency initiative drives changes for 2027 Match
Jan. 21, 2026, David Mitchell — Family medicine residency programs and applicants will benefit from several changes in the 2027 National Resident Matching Program sparked by the AAFP’s Residency Selection Improvement Initiative (RSII).
The Academy launched the initiative in August 2025 to identify improvements that could be put in place within a year or two to help fill more family medicine positions in the National Resident Matching Program (NRMP)’s Main Residency Match as effectively, efficiently and economically as possible.
Karen Mitchell, MD, FAAFP, AAFP vice president for national residency and academic partnerships, said this month that the Academy expects to have significant changes in place by June.
“At our convening in August, stakeholders identified four priority areas,” Mitchell said. “I am pleased how quickly efforts on these have progressed.”
Family medicine welcomed nearly 5,400 first-year residents in 2025, the largest first-year resident class in the specialty’s history. Family medicine residencies offered a record number of positions for the 16th year in a row, and more than 800 residency programs filled 4,574 positions in the Main Match. That left 805 positions unfilled prior to the Supplemental Offer and Acceptance Program.
Karen Mitchell, MD, FAAFP, vice president for national residency and academic partnerships, will share updates about the AAFP's residency initiative at the 2026 Residency Leadership Summit.
The AAFP’s residency initiative aims to improve recruitment and selection for both applicants and programs. The effort includes participation from the Association of American Medical Colleges (AAMC), the NRMP, the Association of Family Medicine Residency Directors (AFMRD) and a cross-section of members who are students, residents, advisors and residency staff, including representatives of other national family medicine organizations.
Centralized residency information
The AAFP already offers an online residency directory, but Mitchell said applicants are using multiple online tools and need a centralized resource. RSII project leaders worked with key stakeholders, including program directors, coordinators, residents and applicants, to refine and prioritize a list of family medicine-specific residency information that applicants are searching for.
To that end, the AAFP is working with the AAMC to incorporate information from the Academy’s directory into Residency Explorer, a product of the AAMC and eight other stakeholders. The collaboration will let family medicine residencies:
- Identify three top strengths that help define their program, such as an emphasis on geriatrics, sports medicine or other areas within family medicine.
- Describe their community setting as rural, suburban or urban.
- Tell applicants whether the family medicine clinic is federally funded to help those who hope to practice in related settings in the future.
- Specify the level of pregnancy care training they provide—the 20-delivery minimum required by the Accreditation Council for Graduate Medical Education for family medicine residents, the 80 deliveries required for comprehensive pregnancy-related care in independent practice, or a combination.
Mitchell said the AAFP will continue to maintain its residency directory. She urged program directors to keep their information updated there “because it will be the mechanism for collecting this program information.”
“It will only be as accurate as what residency programs report,” she said.
Residency programs are also encouraged to update their program descriptions in the National GME Census, a component of the AAMC’s GME Track conducted jointly by the AAMC and the AMA. Residency Explorer and the AMA’s residency search tool FRIEDA are populated by this information.
“Family medicine applicants are telling us that the community being served is very important information,” said Mitchell, who noted the Academy gleans information about student priorities from a student member survey, direct member feedback, interviews and participants in the RSII’s August meeting. “We are asking for residencies to include an expanded community description, which could include things like demographic information or languages spoken.”
Reimagining the residency interview process
Mitchell said the RSII aims to make the interview offer and acceptance process easier, equitable, and more effective for programs and applicants. Representatives of the AAFP and AFMRD have talked with residency directors from other specialties to learn what has worked and what hasn’t in other areas of medicine.
An RSII workgroup is discussing the timing of offering and holding residency interviews. For example, although residencies receive applications through the Electronic Residency Application Service starting Sept. 24, pediatric residencies will not offer interviews before Oct. 6.
“Family medicine currently has no specific guidance on when to offer interviews,” Mitchell said. “Giving programs more time to holistically review applications would allow them to really search for mission-aligned applicants. It also would remove pressure on applicants to say yes to every offer and give them time to consider their priorities. With 800 programs and so many differing approaches, it’s confusing to medical school advisors and applicants, and creating unnecessary stress.”
Mitchell said that during the Residency Leadership Summit (RLS), which comes to Dallas March 4-6, the RSII will propose some interview offer guidelines and seek attendee input.
IMGs and multispecialty applicants
The AAFP is working with the Electronic Residency Application Service to develop a way to help programs understand which applicants are most committed to family medicine and best align with their mission. The focus is to help residencies decide which applicants to invite for interviews, including by discerning how well applicants who apply to more than one specialty are aligned with family medicine.
Mitchell said the RSII is also taking a “deep dive with key collaborators” to help better understand the barriers programs face in choosing international medical graduates (IMGs) and to find potential solutions. Plans include collating IMG recruitment resources and guidance by June, and continuing work all year.
Supporting future family physicians
The RSII also is prioritizing strategies to support applicants who are dedicated to family medicine on their residency selection pathway. Accelerated programs at institutions including North Carolina, Penn State and Texas Tech that let learners earn medical degrees in three years and connect them to an affiliated family medicine residency program already exist.
“The family medicine accelerated tracks are designed for students committed to family medicine to get the connected to specific residency programs,” Mitchell said. “We think we can learn from that pathway to apply similar support for applicants on four-year pathways.”
Learn more at the Residency Leadership Summit
Mitchell will present a mainstage session with an overview of RSII during the Residency Leadership Summit in March. Workshops and breakfast tables will also feature related topics such as data-informed recruitment strategies, Match week preparation, IMG inclusion and opportunities for RSII input.
“We expect to have some high-impact, short-term RSII goals met by June 2026,” Mitchell said, “with more complex, high-impact opportunities for 2027.”