2025 Adult Rheumatology Fellowship Match is Strong (Again) Save

The American College of Rheumatology (ACR) announced today that 2025 Medicine and Pediatric Specialties Match results show rheumatology fellowship positions continuing to fill at high rates. The Match uses a computerized process to pair applicant and program preferences, determining where physicians will complete subspecialty training.

National projections continue to warn of a widening gap between the number of patients living with rheumatic and musculoskeletal diseases and the available rheumatology workforce, especially in rural and underserved areas.

Adult Rheumatology Trends

Across adult rheumatology, total fellowship programs slightly increased, but the number of available positions grew by fifteen, expanding capacity for incoming fellows. Despite this increase in positions, the number of individuals ranking adult rheumatology as their preferred specialty decreased by approximately 2.6 percent, representing about ten fewer applicants choosing rheumatology as their top choice. However, there is still more demand than supply.

At the same time, the number of individuals matched to rheumatology rose by about 4 percent (11 additional fellows), while the number of unmatched applicants fell by 4 percent (21 fewer individuals). The decline in unmatched applicants largely reflects the combination of more available fellowship positions and a smaller pool of candidates ranking adult rheumatology first.

“These data tell a nuanced story: we are working to expand fellowship positions, and while there was a slight decrease in the overall applicant pool, demand for fellowship spots in adult rheumatology continues to outpace supply,” said Anisha Dua MD, MPH, chair ACR Committee on Training.  “Addressing long-term shortages will require continued efforts to expand positions while enhancing the visibility of rheumatology to trainees in the pipeline.”

Pediatric Rheumatology Concern

In pediatric rheumatology, the apparent increase in the percentage of filled positions in 2026 is largely driven by a reduction in available positions and a smaller applicant pool, rather than a true improvement in demand. Total certified pediatric rheumatology programs decreased from 36 in 2025 to 33 in 2026, which contributed to a drop in available fellowship positions from 55 to 44 slots.

In 2025, 27 of 55 pediatric rheumatology positions were filled (49 percent), compared with 24 of 44 positions filled in 2026 (54 percent), representing a 20 percent decrease in the number of available positions year over year. Therefore, if the number of positions available in 2025 had remained consistent, the fill rate would have shown a decline in 2026. Similarly, the number of individuals indicating pediatric rheumatology as their preferred specialty declined from 28 in 2022 to 24 in 2026, a 14 percent decrease in those expressing interest. These trends are not unique to rheumatology and are concerning for pediatric subspecialty care in general.

“Pediatric rheumatology is experiencing a concerning combination of shrinking program capacity and fewer applicants listing the field as a top choice,” said Ekemini Ogbu MD, MSc, chair, ACR Committee on Pediatric Rheumatology. “Without targeted efforts to grow and support the pediatric rheumatology pipeline for both clinical care and research, children and adolescents with complex rheumatic diseases will face increasing delays and barriers to timely diagnosis and appropriate care resulting in poorer outcomes. In addition, the existing workforce will also face a higher risk of burnout.”

ACR Actions and Call to Action

To address these challenges, the ACR is advancing a multi-pronged strategy that includes advocacy for expanded graduate medical education funding, innovative training models, and incentives to recruit and retain both adult and pediatric rheumatologists. The College is also enhancing mentorship, outreach, and early exposure initiatives to help more medical students and residents discover both adult and pediatric rheumatology as rewarding career paths. The ACR is also strengthening external partnerships within the pediatric community and collaborating on initiatives that could improve the pipeline for pediatric subspecialties.

“This year’s specialty match highlights important trends in the rheumatology workforce: a continued strong showing in adult rheumatology training positions alongside a less favorable pediatric match that reinforces the ongoing need for targeted efforts to support and strengthen the pediatric rheumatology pipeline. But match numbers alone do not tell the whole story,” said Beth Jonas, MD, FACR, chair of the ACR Workforce and Training Committee. “Policymakers, training programs, and health systems must work together to stabilize and grow the rheumatology workforce so that every patient—can receive timely, expert care.”