• Anuj Kailash Aggarwal, Meredith Barad, Nu Cindy Chai, Timothy Furnish, Puneet Mishra, Lynn Kohan, Susan Moeschler, Rajiv D Reddy, and Bhavana Yalamuru.
• Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University, Stanford, California, USA akaggarw@stanford.edu.
• Reg Anesth Pain Med. 2024 Sep 3.

AbstractThe National Resident Matching Program (NRMP) for pain medicine fellowships marked its 10th anniversary in 2023, coinciding with growing discussions within the Association of Pain Program Directors (APPD) regarding the program's future in the context of a recent decline of applicants into pain medicine. This letter explores the rationale behind reassessing the NRMP's utility for pain medicine, examining historical and current trends, and considering the implications of withdrawing from the match. Despite a recent decline in applicants and an increase in unfilled positions, the APPD advocates for continued participation in the match. The match ensures equitable and stable recruitment, preventing the chaotic pre-match environment of competitive, early offers. Data from similar specialties highlight the pitfalls of non-match systems, such as increased applicant pressure and reduced program visibility. The APPD supports maintaining the NRMP match while implementing reforms like preference signaling to address evolving challenges. The APPD aims to preserve the match's benefits and ensure a stable future for pain medicine fellowship recruitment.© American Society of Regional Anesthesia & Pain Medicine 2024. No commercial re-use. See rights and permissions. Published by BMJ.

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