Background This study evaluates trends in Hematology-Oncology fellowship match outcomes from 2014 to

2025 using National Resident Matching Program (NRMP) data. The analysis focuses on the

distribution of matched applicants among U.S. allopathic graduates (US MDs), osteopathic

graduates (DOs), U.S. international medical graduates (US IMGs), and non-U.S. international

medical graduates (non-US IMGs). Understanding these trends can inform future applicants,

training programs, and policy-makers regarding the evolving competitiveness and accessibility

of this subspecialty.

Methods NRMP Hematology-Oncology fellowship match data from 2014 to 2025 were obtained from

publicly available reports; projected data for 2025 were included when available. Extracted

variables included the number of participating programs, positions offered, positions filled, and

overall fill rates. Applicant groups analyzed included US MDs, DOs, US IMGs, and non-US

IMGs (including Canadian graduates). Key metrics included group-specific fill rates, total match

numbers, and outcomes such as first-choice matches and unmatched rates. Trends over time were

assessed using simple linear regression, with statistical significance defined as P < 0.05.

Results The number of Hematology-Oncology fellowship programs increased by 76.92%, from 130 in

2014 to 230 in 2025 (P < .001), representing an average annual increase of 5.3%. Fellowship

positions grew by 49.51%, from 517 to 773 over the same period (P < .001), with an average

annual increase of 3.7%, reflecting rising demand and institutional investment.

The overall fill rate improved by 2.6%, reaching 99.7% in 2025 compared to 97.1% in 2014,

underscoring increasing competitiveness.

The proportion of US MDs matched rose from 52.19% in 2014 to 55.38% in 2025. The total

number of matched MDs (including US MDs, US IMGs, non-US IMGs and Canadian graduates)

increased by 49.05%, from 475 to 708 (P < .001). The proportion of US DOs matched increased

from 5.37% (n = 27) in 2014 to 8.2% (n = 63) in 2025 (P < .05), with an average annual growth

of 5.62%.

The overall proportion of IMGs matched (including US IMGs, non-US IMGs, and Canadians)

declined slightly from 42.5% in 2014 to 36.4% in 2025 (P > .05). Within this group, US IMG

match rates rose modestly from 9.0% to 9.33% (P > .05), while non-US IMGs (including

Canadians) decreased from 33.5% to 27.1% (P < .05).

Applicants matching at their first-choice program increased by 45.96%, from 272 in 2014 to

397 in 2025 (P > .05), with an average annual increase of 3.80%. The percentage of applicants

who did not match into Hematology-Oncology but matched into another specialty decreased

from 6.5% to 3.0% (P > .05). However, the overall unmatched rate rose from 20.6% in 2014

to 25.2% in 2025 (P < .05), indicating a growing level of competition in the specialty.

Conclusion Hematology-Oncology has seen substantial growth in both program numbers and match fill rates

over the past decade, reflecting increasing interest and clinical demand. The rising match rates

among US MDs and DOs point to greater access for domestic graduates, while the relative

decline in match rates among non-US IMGs suggests increased competition. These trends likely

mirror broader dynamics such as the global rise in cancer incidence, therapeutic innovation, and

expanded research opportunities in the field. Continued surveillance of match outcomes may

help guide applicant decision-making and inform fellowship program policies, including

international recruitment and training capacity planning.

References 1.National Resident Matching Program, Results and Data: Specialties Matching Service 2014

Appointment Year. National Resident Matching Program, Washington, DC. 2014.

2.National Resident Matching Program, Results and Data: Specialties Matching Service 2025

Appointment Year. National Resident Matching Program, Washington, DC. 2025

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