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America’s medical residents, by the numbers

Patrick Boyle, Senior Staff Writer
December 1, 2021

The AAMC 2021 Report on Residents shows trends in demographics as well as specialty and geographic preferences among doctors in training.

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Medical school not only teaches the nation’s future doctors about medicine, but it also helps them to explore their own skills and interests — which helps to explain why most students change their preferred specialties by the time they graduate.

The country’s newest medical residents begin their post-medical school training having devoted many hours to volunteer work, led by those who specialize in obstetrics and gynecology and in pediatric internal medicine.

And people from races and ethnicities that have traditionally been underrepresented in the medical field continue to expand their presence in residency training. Women now account for more than half of the medical residents in psychiatry, in addition to increasing their majorities in several other fields.

These are among the findings in the 2021 Report on Residents, the latest annual AAMC compilation of data on the characteristics of medical school graduates and residents, including test scores, demographics, and professional activities after residency — the multiyear training period when medical school graduates practice at hospitals and clinics under close supervision. Below are some selected findings.

More medical residents

The number of active medical residents covered in the annual report increased from 139,848 in 2020 to 144,660 in 2021. This table shows the numbers of residents by type of medical school, graduate medical education specialty, and gender.

Meanwhile, the percentage of residents who are international medical school graduates has declined in recent years, going from 25.9% in the 2015 report to 23.0% in the 2021 report.

Diversity

Race

Racial diversity varies greatly among specialties, as this data table shows. The percentage of medical residents who identify as Black or African American and as Hispanic, Latino, or of Spanish origin increased from those in the 2020 report. The 2021 percentages are:

  • White — 50.0%
  • Asian — 21.8%
  • Hispanic — 7.8%
  • Black or African American — 5.8%
  • American Indian or Alaska Native — 0.6%
  • Native Hawaiian or Other Pacific Islander — 0.2%

(Note: Medical residents could choose more than one race/ethnicity. Race/ethnicity is presented only for U.S. citizens and permanent U.S. residents.)

Gender

Among the specialties with the most medical residents, women continue to make up a larger percentage of those in family medicine (54.2%), obstetrics and gynecology (85.2%), and pediatrics (72.7%). There are also now slightly more women than men residents in psychiatry (accounting for 50.2%), which is a change from previous years. Men make up a larger percentage of medical residents in anesthesiology (66.6%), emergency medicine (62.8%), and internal medicine (56.4%), among others. See the gender distribution by specialty.

Specialty changes and continuity

Only 27.0% of the 2020-21 graduates intended to train in the specialties they had listed as their preference when they began medical school — a figure that’s consistent with the rate of the past several years. Almost half (48.7%) changed their stated preferences from the start of medical school to residency; the rest had been undecided or didn’t report a preference.

Medical school graduates who plan on entering the specialties below were most likely to have named different specialties when they began medical school. (Figures show the percentages of new residents who had previously identified a different specialty.)

  • Vascular surgery — 84.8%
  • Preventive medicine — 83.3%
  • Urology — 70.7%

Alternatively, “specialty preference continuity” — the rate at which students graduated with the same specialty preferences as when they began medial school — were the highest in these specialties:

  • Orthopaedic surgery — 45.7%
  • Pediatrics — 41.7%
  • Emergency medicine — 39.3%
  • Neurological surgery — 36.0%

Specialty preference continuity was 28.2% in family medicine and 29.9% in internal medicine. See more about how specialty preferences changed or stayed the same for various specialties.

Service

First-year medical residents had routinely pursued volunteer opportunities in health and medical care. Those reporting the highest average number of volunteer experiences (per person) were in obstetrics and gynecology (8.9), internal medicine/pediatrics (8.9), otolaryngology (8.6), and plastic surgery: integrated (8.4).

Staying in state

The place where doctors practice their residencies has a big impact on where they continue practicing after they complete that training. A majority of medical residents (57.1%) who completed residency training from 2011 through 2020 continue to practice in the state where they completed their residencies. The rate among those who completed training from 2010 to 2019 was 55.5%.

Among states, physician retention after medical residency is highest in California (77.8%) and lowest in Delaware (41.5%), as this table shows.

Dual degrees

In the most recent reporting year (2020), 3.3% of active medical residents who graduated from U.S. MD-granting schools were dual MD-PhD graduates. Medical Genetics and Genomics had the highest percentage of active U.S. MD-PhD graduates (24.4%). This table shows the numbers of residents with MD-PhDs by specialty.

Paths to academia

Among those who completed medical residency training from 2011 through 2020, about 1 in 5 (20.2%) hold a full-time faculty position at an MD-granting school in the United States. This table shows faculty appointments by specialty.

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