Demographic Differences Between Applicants Who Submitted Rank Order Lists and Applicants Who Matched in 2022 and 2023

<b>Background</b> Resident selection processes may alter the representation of applicants with certain demographic characteristics. The impact of potential biases at each phase of selection should be examined. <b>Objective</b> To investigate the differences between applicants who submit rank order lists (ROLs) and applicants who match in the National Resident Matching Program (NRMP) Main Residency Match. <b>Methods</b> We analyzed publicly available NRMP data for the 2022 and 2023 Matches to compare self-reported sex, sexual orientation, race, ethnicity, disability status, and citizenship between applicants who submitted ROLs and applicants who matched. <b>Results</b> Of the 73 426 applicants who submitted ROLs, 60 655 applicants matched. A higher percentage of matched applicants were female as compared to those who submitted ROLs (+2.0%, 95% CI, 1.4 to 2.5). A higher percentage of matched applicants identified as bisexual (+0.2%, 95% CI, 0.04 to 0.4), whereas a lower percentage of matched applicants identified as heterosexual (-0.4%, 95% CI, -0.7 to -0.1). White applicants represented a higher percentage of matched applicants (+2.9%, 95% CI, 2.3 to 3.4), whereas Asian and Black/African American applicants comprised lower percentages of matched applicants as compared to all applicants (Asian: -1.5%, 95% CI, -2 to -1; Black/African American: -0.6%, 95% CI, -1 to -0.3). Hispanic/Latino and non-US citizens also comprised lower percentages of matched applicants (Hispanic/Latino: -0.5%, 95% CI, -0.8 to -0.1; non-US citizen: -4.9%, 95% CI, -5.3 to -4.5). There was no difference for applicants with disabilities. <b>Conclusions</b> Differences exist between the demographics of applicants who submitted ROLs compared to those who matched.