I was curious after examining the Match data tables. The trend in the fill rate for FP is heading way way down, having already hit a historical low in 2003. So my question is: who fills all the empty FP programs in the US? What, it can't be all IMG's, right? According to the stats, roughly 25% of FP residents are IMG. However only about 40% of FP residents are AMGs. Are schools just shunting their less academically stellar students into FP programs outside of the Match? Do programs that go empty close down? Does an unfilled program desperate for residents start handing out J-1's and H1B's first come first serve in the scramble? Or do FP's appear out of thin air and start working in that rural unopposed hospital in the middle of Nowhere, USA? What are the ACGME guidelines/regulations for empty or nearly empty residency programs? Do they still get federal funding? Do the slots get transferred to another more popular program within the hospital system? Are all the unfilled programs filled completely through the Scramble? And so curiosity kills the cat.... Sorry if my questions are transparently dumb.