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The paper focuses on the past five years of National Residency Match Program (NRMP) information in the Unites States with a comparison point of twenty years ago utilized because of a referenced article. It is well known to our students going through the match that it is more competitive than in prior years. To rank enough programs for your field, take Step 2 early to maximize your score, to get quality letters and to practice mock interviews. The 99% match rate has remained steady over the past five years despite an increase in all primary care disciplines particularly Internal Medicine. Family Medicine and Internal Medicine work with, on average, about half U.S. seniors and half from other groups including Osteopathic and IMG (U.S. citizen and non-U.S. citizen). This can create a holistic experience for residents with a sharing of ideas from students from varied backgrounds. While the Supplemental Offer and Acceptance Program appear as an initial success, the student's goal should be to avoid such a step altogether. The key twenty years ago and today is the existence of appropriate numbers of resident and faculty role models. This is a stressful goal considering the demands on faculty for billing and patient care due to the shiftwork nature of the new work hours. [ABSTRACT FROM AUTHOR]

Abstract: This perspective attempts to bring graduate medical offices, residency programs and medical students interested in categorical internal medicine (CIM) a brief update on the American Board of Internal Medicine (ABIM), Accreditation Council for Graduate Medical Education (ACGME) and the National Registry for Medical Programs (NRMP) changes for the past 3–5years in the United States (US). The US model for certification and recertification may serve as a homogenous example for other countries. This model will be described so that there is an understanding of the importance of such changes in the American system and its effect on resident education. This is critical knowledge for both teachers and learners in internal medicine in preparation for a lifetime career and requirements for certification/credentialing for both programs and their residents/fellows. Data from the review indicate a small increase in the number of applicants but a concordant decrease in ABIM initial certification exams. Programs should well be aware of the new focus on outcomes via the Next Accreditation System (NAS) being put forth by the ACGME. [Copyright &y& Elsevier]