According to the current AMA news, medical schools are markedly increasing their enrollments such that there will 19909 allopathic and 5227 osteopathic students admitted in 2012. This is a total of US medical school 25136 spots per year. http://www.ama-assn.org/amednews/2008/06/23/prsb0623.htm The number of Medicare funded resident spots was capped in 1997 and there are ~24000 first year residency spots. http://www.amsa.org/tnp/articles/article.cfx?id=92 http://goliath.ecnext.com/coms2/gi_0199-6095908/BBA-impacts-on-hospital-residents.html With the large U.S. budget deficits IMHO THE prospects for large increases in the cap on resident spots are slim at best. This is going to make the match much more competitive in the future as you have more and more medical students competing for a basically fixed number of spots. There clearly will not be enough residency slots for all the US allopathic, US osteopathic, US IMGs, and non-US IMGs who will be applying for the match. I think it is going to be very rough for those medical students who graduate and are unable to get into a residency. P.S. The following quote in the article I think is worth pondering The number of first-year residency positions has grown only 4% over the past 10 years. Without residency slots increasing at the same rate as school seats, the larger U.S. classes will end up replacing international medical graduates in the residency pool, not expanding the total number of physicians, Salsberg said.