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no PD would choose to have spots unfilled rather than having them filled.
Traditionally not true. Not sure how the new all in policy will affect program behavior. However, I would rather take my chances filling outside the match than to rank and match a candidate that interviewed and was universally felt to be a bad fit for the program. The rule of thumb for the program is, be careful who you rank at the bottom of your list, because you just might end up with them in your program for the next three or four years.
This explains the above post where someone interviewed at and ranked Michigan and the applicant went further down the list than Michigan, yet Michigan had unfilled positions. That means that the program decided it would be better to have an unfilled position than to rank that candidate. Most programs, in all specialties, I know of have a list of people who interviewed, but did not get ranked. Sometimes a candidate is just not a good fit, for whatever reason.