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Is it getting harder to match?

Yes!

With each passing year the number of applicants to US residencies increases significantly, with only a modest increase in residency positions.

 

Source: http://www.nrmp.org/data/Main2011.jpg

This is likely due to a number of reasons.

  1. There are increasing numbers of non-US students (foreign) applying to US residencies
  2. There are increasing numbers of US students from non US schools (usually the Caribbean)
  3. There are increasing numbers of medical schools opening
  4. Medicaid has not increased its funding for residency positions at the same rate as #1,2,3

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