Objective Osteopathic (DO) medical students encounter unique challenges applying and matriculating to postgraduate training programs. To better understand these challenges and where DO students matriculate for residency, we aimed to examine program characteristics associated with higher DO resident representation among postgraduate programs in the United States. Methodology We conducted a retrospective, cross-sectional study of Accreditation Council for Graduate Medical Education (ACGME) accredited residency programs within the 10 largest specialties (i.e., with the most training spots) cataloged within the Fellowship and Residency Electronic Interactive Database Access (FREIDA) dataset in 2022. We explored program-level characteristics associated with DO representation, DOs constituting ≥33% of residents, presenting descriptive statistics and risk ratios (RR) with 95% confidence intervals (CIs) clustered at the sponsor level. Each level of non-binary categorical variables was analyzed as an indicator variable, while continuous variables were rescaled by dividing by two standard deviations to facilitate comparing the strength of associations between DO representation and each program-level characteristic. Results Of the 3,364 programs from the 10 specialties included in the study, 2,284 (67.9%) had <
33% DO residents, and 1,080 (32.1%) had ≥33%. Former American Osteopathic Association (AOA) accreditation was more common at programs with ≥33% DO residents (