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Objective:
Each year nearly 40,000 medical students apply to residency through the National Resident Matching Program (NRMP). Last year, 8,000 applicants were not matched with a residency program. Recently, with changes to licensing exams and renewed interest in certain specialties such as diagnostic radiology, it has become more difficult to determine which applicants will match. It is well established that applicants who rank more programs, score higher on their licensing exams, and publish more articles have a better chance of matching. We sought to determine a “magic number” of programs that an applicant could rank to be comfortable that they would match to a diagnostic radiology (DR) residency. This magic number has been previously defined as the number of ranks an applicant needs to have a greater than 90% chance of matching. We hypothesized that this magic number increased over the last 8 cycles, coinciding with anecdotal reports of radiology’s increasing competitiveness.

Materials and Methods:
Charting Outcomes in the Match, the NRMP’s semiannual document containing characteristics of applicants, was accessed from 2014 -2022. Data were extracted for matched and unmatched DR applicants (US MD Seniors) in categories including number of ranks, USMLE Step 1 and 2 scores, and number of published abstracts. Analysis was conducted via chi-square analysis.

Results:
Compared to the average applicant, those in DR were significantly more likely to match in 2014, 2016 and 2020 (p < 0.01 for all), and significantly less likely to match in 2018 and 2022 (p = 0.03 and p < 0.01, respectively). The magic number generally trended upwards, from 5 in 2014 to 14 in 2022. Step 1, Step 2, and number of published abstracts all trended upward during the same time period.

Conclusion:
From 2011 - 2016, DR as a specialty was having a difficult time attracting competitive applicants to the field, due in part to a weak job market. This trend was illustrated by the "magic number" based on 2014 and 2016 NRMP match data, which was 5 and 2. respectively. Between 2014 and 2016, the average Step scores fell. From the nadir of 2 in 2016, the magic number increased to 14 in 2022. The rise in magic number paralleled the surge in average Step 1 and Step 2 scores between 2016 and 2022. Both of these trends likely represent increasing competition within the field, which shows no signs of stopping. This may be in part due to the increased emphasis on telemedicine that occurred during the COVID-19 pandemic. Students, who previously had cited lack of patient contact as a major reason to not apply into radiology, may not have prioritized patient contact as highly after the pandemic. It could also be due to an improved job market, increased mentorship, and elective availability for medical students, or interest in interventional radiology. More research is needed to determine the exact factors that are influencing the competitiveness of this specialty and what factors applicants can focus on to best improve their chances of matching.