These figures vary widely by specialty, degree type (MD vs. DO), and whether or not a student is classified as an international medical graduate (IMG).
Program signals are a newer piece of the process that allows medical students to identify preferred programs earlier in the Match process. Signals have decreased the number of applications in recent years and lowered the cost of the residency application process.
Let’s talk about how these numbers break down and how you can use them when applying to residency programs to boost your match chances.
For the 2025/26 cycle, total residency applications are down about 5% — from over 52,000 to just under 50,000. However, an applicant’s average applications submitted per specialty remained steady at around 36.
Below is a table showing the average number of applications submitted by each applicant, per specialty.
| Specialty | U.S. MD | U.S. DO | IMG |
|---|---|---|---|
| Anesthesiology | 33 | 42 | 47 |
| Child Neurology | 27 | 34 | 20 |
| Dermatology | 35 | 32 | 32 |
| Family Medicine | 30 | 38 | 47 |
| General Surgery | 52 | 60 | 73 |
| Internal Medicine | 28 | 46 | 88 |
| Medicine-Pediatrics | 30 | 30 | 9 |
| Neurological Surgery | 62 | 49 | 55 |
| Neurology | 40 | 60 | 51 |
| Orthopaedic Surgery | 39 | 36 | 44 |
| Otolaryngology | 44 | 44 | 41 |
| Pathology | 36 | 50 | 63 |
| Pediatrics | 26 | 40 | 44 |
| Physical Medicine and Rehabilitation | 40 | 47 | 32 |
| Plastic Surgery | 69 | 53 | 45 |
| Psychiatry | 58 | 75 | 64 |
| Radiation Oncology | 38 | 44 | 33 |
| Radiology | 59 | 65 | 52 |
| Thoracic Surgery | 27 | 15 | 16 |
| Urology | 45 | 41 | 47 |
| Vascular Surgery | 53 | 41 | 34 |
Source: Association of American Medical Colleges (AAMC)
The ideal number of residency programs you should apply to varies widely depending on a number of factors. If you’re looking for a general number, we recommend you apply to at least 80 programs across 2-3 specialties — or 30-40 applications per specialty.
Here are the biggest factors in deciding your unique number of applications to aim for:
Example: For the best chance of matching into your preferred specialty, you should be in the ballpark of the averages found in that chart. (For instance, if you’re a U.S. DO student interested in anesthesiology, consider applying to roughly 42 programs.)
Don’t forget about application fees. Student loans may cover these, but not always. Consider your financial burden when determining your ideal number of applications. Read more about fee assistance here.
ERAS application fees are as follows:
Ultimately, your best bet for deciding how many specialties and programs to apply for is 1-on-1 support from a residency Match advisor. A qualified advisor can help maximize your chance of success, given your individual circumstances.
Residency admissions have become more competitive since 10 years ago — even though the famous NRMP Match algorithm has remained largely the same. Today’s medical students typically submit more applications than applicants did in 2015.
The growth in submissions has placed a burden on residency program directors, who must sift through ever-increasing piles of applications. The result? First off, AI is being incorporated into the review process. Secondly, more applicants are screened out at a glance, based on GPA and test scores.
For a variety of reasons, here are some of the least competitive specialties:
Below is a detailed table of the average applications submitted per student for some of the major fields of medicine, over the years (2015, 2019, 2024, 2026), so you can see the growth rate.
| Specialty | 2015 ERAS Applications | 2019 ERAS Applications | 2024 ERAS Applications | 2026 ERAS Applications |
|---|---|---|---|---|
| Plastic surgery | 23 | 54 | 65 | 64 |
| Internal medicine | 52 | 62 | 78 | 63 |
| Psychiatry | 35 | 52 | 68 | 63 |
| General surgery | 34 | 52 | 67 | 61 |
| Neurological surgery | 38 | 63 | 70 | 60 |
| Radiology | 28 | 57 | 72 | 58 |
| Neurology | 25 | 39 | 52 | 49 |
| Urology | 57 | 69 | 66 | 44 |
| Otolaryngology | 46 | 64 | 57 | 44 |
| Vascular surgery | 10 | 28 | 44 | 44 |
| Family medicine | 46 | 54 | 47 | 42 |
| Orthopedic surgery | 67 | 74 | 62 | 39 |
| Anesthesiology | 28 | 47 | 60 | 38 |
| Pediatrics | 34 | 41 | 44 | 37 |
| Dermatology | 60 | 72 | 57 | 34 |
| OB-GYN | 40 | 61 | 67 | (not available) |
| Emergency medicine | 35 | 58 | 46 | (not available) |
Source: AAMC
Residency program signals have been around for six years or so, and the ability to signal preferred programs may be one explanation for the drop in residency applications per student in the last two cycles.
Learn More In-Depth: Signaling Residencies — A Comprehensive Guide
Over 90% of U.S. medical residency programs allow students to signal them, and a majority of program directors report using signals as a major factor in their application review process.
About 97%-98% of applicants now use signals. Across effectively all specialties, signaling increases your chances of getting a medical residency interview invite.
Pro Tip: I strongly recommend you max out your limit of residency program signals (gold, silver, and non-tiered) to ensure you have the best shot at getting an interview at your preferred programs.
Read Next: Medical Resident Salary
International medical graduates (IMGs) may have a tougher time getting matched because they attended a non-U.S. medical school, including Caribbean medical schools. But there are ways to increase your chances of matching if you’re an IMG, such as submitting more residency applications.
On average, IMGs apply to nearly double the number of residency programs as U.S. medical graduates. Nevertheless, a lower percentage of IMG applicants receive interviews and match offers than U.S. med students.
Pro Tip: I recommend that IMGs apply to 100+ medical residency programs with the goal of securing 8-10 interview invites. That should give you an 80%-90% chance of matching, but that could vary depending on the quality of your application.
IMGs need to consider the following when applying (whereas a U.S. student doesn’t):
Why do IMGs struggle to get interviews? The fact that IMGs are offered fewer interviews is likely due to visa hurdles, English proficiency, intense competition from U.S. graduates, and program directors having a harder time gauging the quality of international graduates.
Read Next: ERAS Timeline Guide
The average applicant submits 82 applications but receives an average of only 12 interview invites.
Based on anecdotal data, U.S. DO and MD applicants typically receive 12-16 residency interviews while IMGs get around 8-12 invites. AAMC and the National Resident Matching Program (NRMP) don’t publish official interviews-per-applicant data.
For your fourth-year rotations, you can choose elective rotations that help you explore potential specialties you might want to pursue or “audition” for specialties you know you want to apply for.
Since you’ll likely apply for 2 or 3 specialties, feel free to go for 1 competitive specialty (like dermatology) and 1-2 less competitive specialties (like family medicine).
Depending on the competitiveness of your application, you can select elective rotations in a competitive specialty to boost your chances of a “reach” program, or you can find rotations related to the less competitive specialties to solidify your chances of matching somewhere.
Your board scores strongly impact your residency application’s competitiveness. Even if they’re discouraged from doing so, many program directors screen out applications based on GPA and board scores before holistically reviewing them.
Since USMLE/COMLEX Step 1 is now graded as Pass/Fail, your Step 2 scores are more important than ever.
If your board scores are weak, you can build up your clinical and research hours, strengthen your GPA, and consider a retake.
An optimized residency application strategy includes the following:
Almost 10% of U.S. students don’t get matched into residency every year, and over 30% of IMGs don’t get matched. Fortunately, you can improve your match rate with us.
Dr. Mandalia is an accomplished medical writer with multiple manuscripts in peer-reviewed journals and a practicing GI physician in the Orlando area. He is the Admissions Advisor for MedSchoolCoach and has extensive experience helping students get into medical school and residency.