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ID Match Background

Infectious Diseases (ID) program directors and the ID community as a whole have been concerned about the declining number of applicants for ID training program positions over the past several years. In 2010 there were 342 applicants (through Electronic Residency Application Service, also known as ERAS®) for 300 positions (1.14 ratio). By 2014 the number of applicants had declined to 254 even as the number of positions increased to 327 (0.77 ratio) and in that same year, 99 positions in 70 programs were unfilled.  IDSA has convened the Task Force for ID Recruitment to investigate ways to increase interest in ID among the best and brightest students and residents, and so recruit additional excellent trainees to the specialty. 


As part of this process, a review of the Match data has shown that while programs are continuing to train a similar number of fellows each year in Infectious Diseases, the number of individuals going through the Match, sponsored by the National Resident Matching Program (NRMP), has declined. Further, data indicate that a percentage of these applicants are taking positions before the Match. 

As stated on the NRMP website, the Match, as intended, “allow[s] applicants and program directors to consider all options before making decisions,” “creates an impartial venue for matching applicants’ and program directors’ preferences,” and “fosters a spirit of fairness.” 

To promote this outcome, the NRMP requires core residency programs, including Internal Medicine, to place all positions in the Main Residency Match under an “all-in” policy. 

In two recent surveys, an overwhelming majority of ID program directors (PDs) indicated the desire for the subspecialty to utilize the Match to fill positions.  In the second survey, a significant majority expressed a strong desire for ID to adopt an “all-in” Match policy. Many cited serious concerns about the integrity of the Match both for the applicants and for the programs. 

While an all-in policy is not currently required for Internal Medicine Subspecialty Program Matches, 75 percent of positions in a subspecialty must be registered through the Match and 75 percent of programs must participate in the Match. 

If utilization of the Match continues to decline, the availability of the Match for all ID applicants and programs will be placed at risk, a scenario which IDSA strongly believes would be detrimental to fellow recruitment and to the ID community as a whole. 

IDSA believes that implementation of an “all-in” policy will provide the applicant with the best way to fully evaluate all programs in order to optimally determine the program that best suits their needs, and for programs to compete equally for the available applicants. Thus, IDSA leadership has developed the following policy to help the specialty thrive in the present and future. 

The IDSA Board of Directors has approved this policy, to be distributed to all Adult Infectious Diseases Fellowship Training Program Directors, as well as all core Internal Medicine Training Program Directors.

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