We analyzed the trends in application to Pediatrics residency with concurrent application to one or more other specialties (parallel applications) between 2009 and 2023.

A retrospective analysis of custom Association of American Medical Colleges Electronic Residency Application Service data of applicants to Pediatrics residency between 2009 and 2023 was conducted. Descriptive statistics and linear regressions were used to identify trends of the percent parallel applying as well as the mean number of specialties and applications submitted. We used descriptive statistics to characterize common specialty combinations with Pediatrics.

The present analysis examined data representing 81 138 unique Pediatrics applicants. The proportion of Pediatrics parallel applicants (65.9% vs 48.4%, P < .001) and the mean number of specialties applied to (4.1 to 3.9, P < .001) declined from 2009 to 2023. The proportion of international medical graduates (IMG) (88.9% [n = 4468] vs 76.5% [n = 1906]; B = −0.90, P < .001) parallel applying decreased while the proportion of MD applicants (17.3% [n = 370] vs 22.1% [n = 485]; B = 0.56, P = .03) parallel applying increased between 2009 and 2023. During that period, the proportion of DO (32.9% [n = 116] vs 34.0% [n = 291]; B = −0.06, P = .21) applicants parallel applying did not significantly increase. Internal medicine (66.9%) and family medicine (60.7%) were the most common specialty combinations for parallel applicants in 2023. Between 2009 and 2023, the mean applications increased for single-specialty (25.3 vs 51.0; P < .001) and parallel applicants (119.7 vs 146.3; P < .001). IMG (127.1 vs 164.6; P < .001), DO (43.5 vs 119.8; P < .001) and MD (53.4 vs 90.0; P < .001) parallel applicants all experienced significant increases in the mean number of applications submitted.

Although fewer applicants are applying to Pediatrics, around 50% of Pediatrics applicants parallel applied with the proportion of parallel applicants decreasing among IMG applicants and increasing among medical doctor applicants. Medical schools, residency programs, and application systems should revisit residency advising and application limits to reduce the strain of parallel application on applicants and residency programs.