The 2026 Specialty Matching Service results confirmed cardiology is a space full of extremes, with some subspecialties filling every available position and others barely breaking a 60% fill rate as cardiology faces continued workforce shortages and a high demand for services.
Here are 10 things to know about cardiology SMS results for 2026:
1. Cardiovascular Disease filled every single position. The subspecialty offered 1,347 positions across 292 programs and filled all 1,347 for a 100% fill rate. This marks the fifth consecutive year it has achieved a 100% fill rate. It remains the single largest fellowship match by volume in all of internal medicine.
2. Demand continues to outstrip supply in cardiovascular disease. A total of 2,141 applicants competed for 1,347 positions, yielding a ratio of 1.6 applicants per position — one of the highest applicant-to-position ratios in the entire match. With 794 applicants going unmatched, more than one in three cardiovascular disease applicants did not secure a spot.
3. U.S. MD graduates secured just over half of cardiovascular disease spots. Of the 1,347 filled positions, 686 (50.9%) went to U.S. MD graduates. International medical graduates — both U.S. citizens (10.8%) and non-U.S. citizens (26.4%) — accounted for a substantial share, highlighting the specialty’s global applicant pool. U.S. DO graduates filled 12.0% of positions.
4. The percentage of cardiovascular disease positions going to U.S. MDs has declined over five years. U.S. MD fill rates for cardiovascular disease have slipped from 69.0% in 2022 to 62.9% in 2026 — a nearly 6-point drop over five years — even as total positions have grown from 1,120 to 1,347.
5. Interventional cardiology joined the SMS for the first time in 2025 — and it’s already highly competitive. Interventional cardiology began participating in the Specialties Match for appointment year 2025. In 2026, it offered 307 positions across 153 programs and filled 236 (76.9% fill rate), with 49 programs going unfilled. The specialty had 247 applicants competing for those spots — a ratio of roughly 0.8 applicants per position, suggesting supply constraints rather than a lack of demand.
6. Interventional cardiology is heavily reliant on international graduates. Only 26.7% of filled Interventional Cardiology positions went to U.S. MD graduates — one of the lowest rates among all internal medicine fellowships. Non-U.S. IMGs accounted for 39.0% of filled spots, placing the specialty among the top five for non-U.S. IMG representation. U.S. IMGs made up another 20.3% of fills.
7. Clinical cardiac electrophysiology is nearly full and international-heavy. CCE offered 150 positions and filled 147 (98.0%). However, like interventional cardiology, it skews toward international graduates: non-U.S. IMGs filled 38.8% of positions — the fourth highest proportion across all specialties. U.S. MD graduates filled just 40.1% of CCE spots. Applicants matched well, with 178 total applicants and a 92.0% match rate among those who ranked the specialty as preferred.
8. Advanced heart failure and transplant cardiology continues to struggle to fill programs. AHFTC offered 127 positions across 74 programs in 2026, filling just 76 positions (59.8% total fill rate). It has hovered in the 48%–60% fill range for five consecutive years, making it one of the most chronically unfilled fellowships in cardiology. With only 88 total applicants for 127 slots, the applicant-to-position ratio is just 0.7 — demand is simply not meeting supply. Of those who did fill, 46.1% were U.S. MDs, 15.8% U.S. DOs, and 26.3% non-U.S. IMGs.
9. Pediatric cardiology is one of the most competitive and consistently filled fellowships in its category. Pediatric cardiology offered 194 positions and filled 191 (98.5% fill rate) — the highest fill rate among all pediatric subspecialties. U.S. MD graduates were the dominant applicant group, filling 58.1% of spots, and the specialty has maintained a fill rate above 92% for five consecutive years.
10. Adult congenital heart disease remains small — and unfilled in spots. ACHD offered just 25 positions across 20 programs and filled 21 (84.0% fill rate). With only 26 total applicants, this is one of the smallest fellowships in the match by volume. The match composition skews toward U.S. MDs (76.2%) compared to other cardiac subspecialties.
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