AAFP launches initiative to improve family medicine Match

Sept. 4, 2025, David Mitchell — Family medicine started the academic year with its largest class of interns, welcoming nearly 5,400 first-year residents. Family medicine is successfully growing the number of residency programs in geographically distributed community settings, exactly where the training of future primary care physicians is needed.

Your participant list was short, about three dozen people, but it aimed to represent every facet of the Match process, correct?

By design, this was a small group of invited participants, but from a very deliberate cross-section that included residency programs, medical schools and learners. We also included major stakeholder organizations. It felt important that we had all these people in the room. For example, we had both program directors and program coordinators who represented not only their residencies, but who also are involved in larger, national organizations. Everyone was very engaged.  

You have participation from the Association of American Medical Colleges and the NRMP. Are those organizations interested in Match changes that would be broader than family medicine?

Part of the discussion that NRMP brought to the table is that if there are any changes in the overall Match process, they would have to be applicable for all specialties. Yet there are some possibilities that might serve family medicine well, helping fill our residency positions in more efficient and effective ways. I was pleased that NRMP and AAMC could provide us data and past experiences from other specialties. They are supporting us in seeking positive, impactful change. If we want to seek changes in the application or Match processes specifically, it’s helpful to have these organizations involved in the discussion.    

What did you learn, or understand better, after hearing from so many stakeholders?

We did detailed work to analyze each element of the journey both learners and programs undertake leading up to the Main Match and SOAP. This process identified significant challenges to helping smooth the way for applicants applying to family medicine and for family medicine residencies finding their applicants. We also identified a series of actions to address these inefficiencies. Generally, the issues and actions the group identified fell into four areas:  

• A centralized “one-stop shop” of more comprehensive residency program information, including things like the communities programs serve, educational experiences they offer, and their applicant selection and recruitment processes. 
• A re-imagined, streamlined interview process that is more transparent and less resource-intensive.  
• A Match process that would reduce reliance on SOAP, and perhaps allow learners with a strong commitment to family medicine to fill positions earlier. 
• Strategies that better support international medical school graduates and multi-specialty applicants. 

By the time we get through the main Match and the SOAP, family medicine has a 98% fill rate. The challenge is that it takes a lot of effort to get there, and the level of effort is increasing for those who are involved in that second part of the Match. The SOAP is a compact two and a half days when career decisions are being made, and it is stressful for programs and prospective residents. These four priority areas could really help us make substantial progress in the next one to two years.  

This initiative is about filling residency slots more efficiently for everyone involved. In the end, we want applicants to be satisfied with the results and for residencies to know they have highly capable and committed incoming residents. If we can help applicants find residencies that align with their interests and values, and reduce barriers for both applicants and residency programs, we will be taking steps in the right direction. There are many other important initiatives working to boost interest in the specialty overall, make family medicine more attractive, and improve understanding of the profession. 

We talked about how applicants get information about potential programs. In some cases, they’re hearing it from other students or from advisors who might not know much about family medicine. There's no centralized, single source of information for medical students to search for residency programs that give both general residency information—such as salary and benefits—and specialty-specific information—such as the types of experiences the residency offers. We will explore how a centralized source of residency information can help show the values of family medicine and allow programs to better reflect their mission and outcomes, in addition to basic residency information.  

What improvements could be made to the AAFP Residency Directory? 

Our AAFP directory has information that is family medicine specific, meaning that there are drop-down menus for areas of experience, clinic type and patient population. The challenge we're finding is that the AAFP directory is only as good as the information programs provide. We want information supplied regularly by programs as well as information based on a program's past history, which would require a database.  

The other need is for residency programs to offer transparent and clear information to applicants about the processes and decision making they use in their recruitment process. It could be things like:

• Are there a certain number of years out of medical school that a program will consider an applicant?
• What kind of interviews will the program be offering: virtual, in person or some combination?
• Will they offer opportunities to get to know the program better through open-houses or in-person visits?  

What we're seeking to do is to is to have a centralized source of family medicine specific information. We want applicants to discover aspects of family medicine training unique to our specialty. Exactly what that looks like is going to take some study and work with other organizations to see what our opportunities are. 

What other Match-related challenges are being targeted?

The discussions were around changing some of the interview processes that would help family medicine applicants make good choices about where and how they're interviewing, and it'll help the programs offer interviews to applicants who most align with their program. We think there are changes that can happen in the process that will help both applicants and programs reduce the stressors they are feeling. 

You had hoped to identify impactful changes that could be implemented within one to two years. Did that happen? 

Yes. The group coalesced around a few major topics and started to identify some of the next steps and organizations that could be involved. One of the big successes from this is the cross-section of people we had in the room and the commitment that we have in being able to move forward together to solve these challenges. 

By having NRMP, AAMC and the American Association of Colleges of Osteopathic Medicine represented, as well as our family medicine organizations—ABFM, the American College of Osteopathic Family Physicians, the Association of Departments of Family Medicine, the Association of Family Medicine Administration, the Association of Family Medicine Residency Directors, the Society of Teachers of Family Medicine—there were voices present that we really needed in the room. There was tremendous excitement about the discussions we are having and a commitment to collaborate and seek changes. We were successful in identifying some of the major areas that we think could have a big impact and implement in the next few years. Some of that is related to the entire application and interview process. Some of it's related to the Match process itself. Some of it goes back to helping applicants find programs and programs find applicants.  

We came up with some threads that really could make a difference. By having buy-in from the organizations that were here, we have some good steps forward. We’re ready to dive into developing specific plans for the workstream threads that emerged in the meeting.  

Within a couple months, we’ll be able to offer more details about exactly what direction this initiative is headed. We expect to have action plans and opportunities to collaborate on issues that were identified by this group. By the time we get to March 2026, we hope to have clear plans in place for implementation during the next one to two years. The convening focused on actions that will have significant impact to improve the family medicine residency selection process. We're very excited about what's coming.