2026 Fellowship Match Results: What IMGs Need to Know

The Biggest Fellowship Match Ever

The 2025 Medicine and Pediatric Specialties Match (for the 2026 appointment year) was the largest in NRMP history. Programs offered 9,950 positions total. Of those, 8,526 were filled — an overall 85.7% fill rate. The applicant match rate was 78.7%.

For IMGs specifically: non-US IMGs matched at approximately 70%. US MD applicants matched at about 91%. DO applicants at about 82%.

Those are the headlines. Here's what actually matters if you're planning your fellowship application.

The Numbers by Subspecialty

Tier 1: Near-100% Fill (Extremely Competitive)

Cardiology (Cardiovascular Disease)

• 1,347 positions offered
• 100% fill rate — every single slot filled
• This is the most competitive IM fellowship, period. Research is essentially mandatory. Many applicants do a dedicated research year.

Gastroenterology

• 759 positions offered
• 99.5% fill rate
• Second most competitive. Procedural skills and strong research expected.

Hematology-Oncology

• 809 positions offered
• 99.5% fill rate
• Research-heavy. Clinical trial experience is a plus.

Tier 2: 95%+ Fill (Highly Competitive)

Pulmonary & Critical Care

• 844 positions offered
• 98.8% fill rate
• Combined Pulm/CCM is standard. ICU experience valued highly.

Rheumatology

• 302 positions offered
• 99% fill rate
• Smaller field. More competitive than many people realize.

Allergy & Immunology

• 177 positions offered
• 98.9% fill rate
• Can apply from either IM or Peds. Small but competitive.

Tier 3: Variable Fill (More Accessible for IMGs)

Endocrinology

• ~484 positions offered
• ~97% fill rate (improved from ~80% in prior years)
• 38.7% of positions filled by non-US IMGs — one of the most IMG-friendly fellowships

Nephrology

• 496 positions offered
• 73% fill rate — significantly less competitive
• 36.2% of positions filled by non-US IMGs
• Many unfilled positions available. Strong job market after fellowship.

Infectious Disease

• 60.9% fill rate — the lowest among all major IM subspecialties
• Down 9.3 percentage points from the prior year
• Lots of unfilled positions. The declining fill rate is driven partly by lower post-fellowship compensation compared to procedural specialties.

What This Means for IMGs

If you're an IMG planning a fellowship application, here's the practical takeaway:

Realistic targets by competitiveness:

• If you have 5+ publications, strong Step scores, a research year, and US-trained: Cards, GI, Hem/Onc are reachable but competitive
• If you have 2-3 publications, solid letters, competitive scores: Pulm/CCM, Rheum, Allergy are strong options
• If you want the best chance of matching: Nephrology, Endocrinology, and ID have the most capacity and highest IMG representation

The new program signaling system (introduced for the 2026 ERAS season) gives fellowship applicants the ability to indicate genuine interest to programs. Use your signals strategically — signal programs where you have a connection or genuine fit.

Don't sleep on the less competitive fellowships. Nephrology has a strong job market. Endocrinology has excellent lifestyle. ID has intellectual satisfaction even if the pay is lower. Matching into a fellowship you enjoy beats not matching into a prestigious one.

Read our full Fellowship Strategy Guide →

*Data from NRMP Specialties Matching Service (SMS) 2025 Match / 2026 Appointment Year. Verified May 2026.*