Dermatology match disparities: analyzing osteopathic vs. allopathic student outcomes post-ACGME/AOA single accreditation system (2020-2024).

Abstract

Context: Dermatology remains one of the most competitive medical specialties, with successful candidates often demonstrating outstanding academic performance, extensive research experience, and strong letters of recommendation. The integration of the Accreditation Council for Graduate Medical Education (ACGME) and the American Osteopathic Association (AOA) into a single accreditation system in 2020 was intended to streamline residency training, but it has raised concerns about how Doctor of Osteopathic Medicine (DO) applicants will perform in dermatology residency match.

Objectives: This study examines the differences in DO and MD match rates following the single graduate medical education (GME) accreditation system, focusing on the match performance of DO dermatology applicants. It also analyzes the match rates of DO students into traditional ACGME (formerly allopathic)- and former AOA-accredited programs.

Methods: A retrospective review of National Residency Matching Program (NRMP) annual reports and the Association of American Medical Colleges (AAMC) Electronic Residency Application Service (ERAS) statistics was conducted for dermatology applicants from 2020 to 2024. Data were analyzed to compare the number of DO and MD applicants and their match rates to traditional ACGME (former allopathic)-accredited and former AOA-accredited programs. Data on the degree types of current residents at all ACGME-accredited residency programs were collected and analyzed. Statistical analyses included chi-square testing and bootstrapping for categorical variables and proportions.

Results: The study included 137 ACGME-accredited dermatology programs, with 26 (18.98 %) having previously received AOA accreditation. The analysis found that there were substantial discrepancies in postgraduate year 2 (PGY-2) match rates (p<0.05) between 2020 and 2024, with DO applicants matching at a lower rate. Furthermore, more DO applicants consistently matched into former AOA-accredited programs than into ACGME-accredited programs. Matched MD candidates outperformed matched DO applicants in terms of United States Medical Licensing Examination (USMLE) Step 1 scores (p=0.002) and research production (p=0.001).

Conclusions: In summary, DO applicants continue to have lower match rates in dermatology than MD applicants, with fewer DOs matching into traditional (formerly allopathic) ACGME-accredited programs. There are several reasons for this disparity. Systemic changes and further studies are needed to improve the success rates of DO dermatology applicants in future application cycles.