Residency Selection Improvement Initiative (RSII)
The AAFP’s Residency Selection Improvement Initiative (RSII) is bringing together family medicine leaders, residency programs, medical students and national organizations to improve the residency selection and recruitment process.
The Residency Selection Improvement Initiative (RSII) was launched by the American Academy of Family Physicians (AAFP) in 2025 to address inefficiencies and challenges in the current residency recruitment and selection process. The initiative focuses on creating a more effective, efficient, equitable and economical process that helps applicants find the right family medicine residency programs — and helps programs identify applicants who align with their mission and values.
The RSII framework
Core goal
Fill all family medicine residency positions in the most effective, efficient and economical way possible.
Supporting vision statement
Help applicants find family medicine programs that align with their values and interests while helping residency programs identify the best applicants for their programs.
The four RSII focus areas
RSII is built around four interconnected strategic priorities designed to improve the residency selection experience for both applicants and residency programs. These efforts are guided by the RSII North Star Leadership Group, which includes residency program directors, coordinators and administrators, medical school advisors, students and residents.
Create a one-stop information tool
Re-imagine the interview process
Improve residency selection and Match for International Medical Graduates (IMGs) and multi-specialty applicants
Support family medicine-dedicated applicants
Why change is needed
The current residency recruitment and selection process creates challenges for both family medicine residency programs and applicants. Programs face increasing application volumes, compressed timelines and significant administrative demands, while applicants often struggle to identify programs that align with their goals and interests.
Despite a record number of family medicine residency positions being offered each year, hundreds of positions remain unfilled before SOAP. This signals an opportunity to improve how programs and applicants connect throughout the Match process.
The Residency Selection Improvement Initiative (RSII) brings together residency leaders, program coordinators, advisors, students and national partners to identify practical solutions that make recruitment more effective, efficient and equitable. By improving transparency, streamlining processes, and helping applicants and programs find the right fit, RSII aims to strengthen the future family medicine workforce.
Get more context: 2026 AAFP Match analysis
Collaborating to improve residency selection
Launched by the AAFP in August 2025, the Residency Selection Improvement Initiative (RSII) brings together stakeholders from across family medicine and medical education to identify and implement improvements to the residency recruitment and selection process.
Participants include the AAFP, AAMC, NRMP, AFMRD, residency program directors and coordinators, medical school advisors, students, residents and representatives from other family medicine organizations.
Through collaborative workgroups and stakeholder engagement, RSII is advancing recommendations and resources that support residency programs and applicants throughout the Match process.
Priority areas and recommendations
RSII workgroups identified several key areas where changes could improve the residency selection process for applicants and programs.
Help applicants find programs that align with their interests and values.
Applicants often rely on multiple resources to research residency programs, making it difficult to compare opportunities and identify programs that align with their career goals and interests.
To streamline the search process, RSII is working with the Association of American Medical Colleges (AAMC) to incorporate family medicine-specific information into the 2026 Residency Explorer™ tool, Careers in Medicine® and the GME Track® Program Survey.
These enhancements will help applicants better understand what makes each family medicine residency program unique by providing information such as:
Program strengths and areas of emphasis
Community setting (urban, suburban, or rural)
Federally funded clinic status
Pregnancy care training opportunities
Community demographics, languages spoken and other program characteristics
The AAFP Residency Directory will serve as the primary mechanism for collecting and maintaining much of this information. Keeping program profiles current and complete will help applicants make more informed decisions and identify programs that best align with their interests and values.
Create a more equitable and less stressful interview experience.
The residency interview process can be challenging for both applicants and programs, with varying timelines, scheduling pressures, and administrative burden. To create a more transparent, efficient and equitable process, an RSII workgroup developed six interview recommendations for family medicine residency programs.
Align interview invitations with program capacity: Offer only as many interview invitations as available interview spots, extending additional invitations as openings occur.
Delay initial interview offers by one week: Allow at least one week after applications are released to conduct mission-aligned application reviews before sending interview invitations.
Provide applicants a minimum two-business-day response window: Give applicants adequate time to thoughtfully accept or decline interview offers before releasing the spot to another applicant.
Establish expectations for interview cancellations: Encourage applicants to provide at least two weeks' notice when withdrawing from an accepted interview.
Communicate application status by December 1: Notify applicants of their status to reduce uncertainty and help both programs and applicants make informed decisions.
Clearly communicate interview format options: Programs may offer virtual and/or in-person interviews and should clearly outline available options and expectations for applicants.
Together, these recommendations aim to improve transparency, reduce administrative burden, support more mission-aligned recruitment and help more family medicine residency programs fill their positions through the Main Match.
Go in-depth with the Interview Guidelines Explainer
Address barriers for IMGs and multi-specialty applicants.
Family medicine residency programs receive applications from many highly qualified IMGs and applicants applying to multiple specialties. RSII is working to increase the number of applicants in each category that are selected for interviews.
To support this effort, the AAFP is providing input to ERAS® and Thalamus® on the development of a family medicine-specific indicator that would help highlight an applicant's interest in family medicine. This additional information could help programs identify applicants who are most likely to align with their mission and rank family medicine programs competitively.
RSII is also developing resources to support residency programs in the evaluation of IMG applicants. These efforts include creating an IMG resource library informed by stakeholder feedback and collaborating with Intealth® and ECFMG® on resources related to IMG applicant selection and residency preparation.
Together, these initiatives aim to increase the number of high-quality IMG and multi-specialty applicants who are selected for interview and support more informed recruitment decisions throughout the Match process.
Make the matching process more efficient and economical for all.
Some applicants enter the Match process with a demonstrated commitment to family medicine and an existing relationship with a residency program through activities such as clinical rotations, mentorship, pipeline programs or other engagement opportunities.
RSII is exploring ways to support these applicants and residency programs by identifying opportunities to strengthen mutually beneficial relationships throughout the residency selection process. The goal is to make the Match process more efficient and economical for both applicants and programs while supporting informed, mission-aligned decision-making.
Working with the AAMC, NRMP, and other stakeholders, RSII is exploring dedicated pathway opportunities and assisting programs interested in developing structured approaches that foster applicant-program relationships. Any future pathway models would be developed in accordance with NRMP rules and guidelines.
Resources and tools
Downloadable resources
Interview Guidelines Explainer
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