All Doctor Specialties Ranked by Competitiveness

Every doctor says their specialty is one of the most competitive, but obviously that can’t be the case. Most of these doctors are wrong, and even ostensibly reputable sources make competitiveness claims based on a single variable because it’s easier. A comprehensive, objective assessment takes far more effort.

That’s why SpecialtyRank.com exists: no opinions, no bias, just the data. 

This guide ranks all 24 medical specialties by competitiveness using the latest 2026 NRMP match data. The index uses five key factors weighted by their importance to competitiveness:

• Step 2 CK scores, weighted at 30%
• Match rate, weighted at 30%
• Research items, weighted at 30%
• AOA status, weighted at 5%
• Top 40 NIH-funded medical school attendance, weighted at 5%

We’ve previously covered the top 10 most competitive and 10 least competitive specialties in separate guides. This article covers all 24 in one definitive ranking, from least competitive to most competitive.

24 | Family Medicine (6.1 Points)

Family medicine consistently ranks as the least competitive specialty, coming in at 6.1 points in 2026, down from 7.3 in 2024. FM physicians provide broad, comprehensive care for patients of all ages, genders, and conditions.

With a near-perfect match rate of 99.1%, the lowest average Step 2 score at 244, and an average of 6.7 research items, family medicine has the lowest bar to entry of any specialty in medicine. It also plays a central role in addressing the primary care physician shortage, which contributes to the large number of positions offered each cycle.

23 | Pediatrics (13.3 Points)

The next-least-competitive specialty is pediatrics at 13.3 points in 2026, essentially unchanged from 13.4 in 2024. Pediatricians provide comprehensive care for infants, children, and adolescents.

With the highest match rate of 99.4%, an average Step 2 score of 249, and an average of 8.5 research items, pediatrics remains one of the most accessible specialties in medicine despite a modest uptick in research averages over recent cycles.

22 | Emergency Medicine (15.2 Points)

Emergency medicine scores 15.2 points in 2026, up slightly from 15.0 in 2024. These physicians provide immediate care for acute illnesses and injuries in emergency settings.

With a match rate of 96.3%, an average Step 2 score of 248, and an average of 8.3 research items, EM remains accessible despite its high-intensity environment. Emergency medicine has moved down the competitiveness ladder from 18th in 2020 to 19th in 2022 to 20th in 2024 to 22nd in 2026, reflecting a consistent trend of declining relative competitiveness as other specialties have grown more demanding.

21 | Psychiatry (22.2 Points)

The next specialty is psychiatry at 22.2 points in 2026, down from 25.2 in 2024. Psychiatrists focus on understanding and treating psychological disorders and distress.

With a match rate of 93.3%, the second-lowest Step 2 score at 246, and an average of 9.8 research items, psychiatry remains one of the more accessible options for applicants, though research averages have risen meaningfully from 7.5 items in 2024.

20 | Child Neurology (28.5 Points)

Child neurology ranks 28.5 points in 2026, down from 34.3 in 2024. Child neurologists diagnose and treat neurological conditions in infants, children, and adolescents.

With a match rate of 97.2%, a Step 2 score of 250, and an average of 11.1 research items, child neurology remains a specialized niche with consistently low competitiveness despite slight increases in research averages over recent cycles.

19 | Pathology (30.0 Points)

Pathology comes in at 30.0 points in 2026, up slightly from 28.0 in 2024. Pathologists examine tissues and fluids to diagnose disease, most often working behind the scenes without direct patient interaction.

With a match rate of 92.8%, an average Step 2 score of 248, and an average of 13.1 research items, pathology sits near the bottom of the competitiveness rankings despite research averages that have climbed significantly in recent cycles.

18 | Internal Medicine (31.5 Points)

Internal medicine scores 31.5 points in 2026, down from 35.0 in 2024. Internists provide primary and specialty care for adults.

With a match rate of 97.4%, a Step 2 score of 252, and an average of 12 research items, internal medicine remains one of the most accessible specialties despite sitting in the middle of the Step 2 score range. In 2026, it filled 11,632 positions, more than double the next most popular specialty, making it by far the largest specialty in the match. That volume reflects its role as the gateway to some of the most sought-after fellowship subspecialties in medicine, including cardiology and gastroenterology.

17 | Neurology (39.3 Points)

Neurology scores 39.3 points in 2026, up from 33.6 in 2024. Neurologists diagnose and treat disorders of the brain, spinal cord, and nervous system.

With a match rate of 93.1%, an average Step 2 score of 251, and an average of 13.3 research items, neurology offers lower barriers to entry than many specialties. A Step 2 score of 251 sits just above the 47th percentile among test-takers, placing it right at the boundary between the less and more competitive half of the specialty spectrum.

16 | PM&R (41.1 Points)

PM&R, or physical medicine and rehabilitation, scores 41.1 points in 2026, up from 37.3 in 2024. These physicians focus on restoring function and quality of life to patients with physical impairments or disabilities.

With a match rate of 82.4%, an average Step 2 score of 250, and an average of 13 research items, PM&R sits solidly in the moderately competitive range, a step above the least competitive cluster despite having a similar Step 2 score to several specialties ranked well below it.

15 | OB/GYN (45.9 Points)

OB/GYN scores 45.9 points in 2026. OB/GYNs focus on women’s reproductive health, pregnancy, and childbirth.

With a match rate of 87.2%, a Step 2 score of 252, and matched applicants averaging 12.5 research items, OB/GYN sits in the moderately competitive range. It shares its Step 2 score with internal medicine and Med-Peds, but the research average has climbed considerably from 9 items in 2024 to 12.5 in 2026.

14 | Med-Peds (46.7 Points)

Med-Peds scores 46.7 points in 2026, down from 50.2 in 2024. This combined specialty trains physicians in both adult and pediatric medicine.

With a match rate of 89.9%, an average Step 2 score of 253, and matched applicants averaging 10.1 research items, Med-Peds sits just above OB/GYN in overall competitiveness. Matched applicants have a higher average Step 2 score than either pediatrics or internal medicine alone, despite a lower research average than both.

13 | Radiation Oncology (49.8 Points)

Radiation oncology scores 49.8 points in 2026, up from 49.5 in 2024. These specialists use radiation therapy to treat cancer and other disorders.

With a match rate of 91.8%, a Step 2 score of 251, and matched applicants averaging 21.3 research items, radiation oncology is a clear example of why match rate alone doesn’t tell the full story. That research average ranks eighth-highest among specialties, pushing radiation oncology above specialties with similar or higher Step 2 scores in overall competitiveness.

12 | Diagnostic Radiology (52.8 Points)

Diagnostic radiology scores 52.8 points in 2026, down considerably from 62.3 in 2024. Diagnostic radiologists interpret imaging studies like X-rays, CT scans, MRIs, and ultrasounds to diagnose disease.

With a match rate of 94.1%, a Step 2 score of 257, and matched applicants averaging 15.4 research items, diagnostic radiology sits in the moderately competitive range despite having one of the higher Step 2 averages on this list. The high match rate keeps its overall competitiveness score lower than its board scores alone might suggest.

11 | Anesthesiology (53.3 Points)

Anesthesiology scores 53.3 points in 2026, essentially unchanged from 53.2 in 2024. Anesthesiologists manage anesthesia and pain during surgical and other procedures.

With a match rate of 87.4%, a Step 2 score of 254, and matched applicants averaging 12.9 research items, anesthesiology sits just above diagnostic radiology in overall competitiveness despite a lower Step 2 average, driven by a meaningfully lower match rate.

10 | Interventional Radiology (56.3 Points)

Interventional radiology scores 56.3 points in 2026, down from 65.7 in 2024. These specialists use imaging guidance to perform minimally invasive procedures.

With a match rate of 91.2%, a Step 2 score of 254, and matched applicants averaging 21.1 research items, IR sits in the competitive range. The drop in points reflects shifts in the broader landscape rather than IR becoming easier to enter, as research averages have continued climbing from 10.3 in 2020 to 15.8 in 2024 to 21.1 in 2026.

9 | General Surgery (60.9 Points)

General surgery scores 60.9 points in 2026, down slightly from 62.7 in 2024. These surgeons manage a broad spectrum of surgical conditions affecting the abdomen, breast, digestive tract, and beyond.

With a match rate of 80.3%, a Step 2 score of 253, and matched applicants averaging 15.6 research items, general surgery serves as a gateway to several surgical subspecialties, much like internal medicine does for medical subspecialties.

8 | Ophthalmology (64.8 Points)

Ophthalmology scores 64.8 points in 2026, down from 71.3 in 2024, when it ranked sixth. Ophthalmologists manage diseases of the eye using both medical and surgical approaches.

Ophthalmology matches through the SF Match rather than the NRMP main match, so its data comes from alternative sources and is less comprehensive than that of other specialties on this list. With a match rate of 72%, a Step 2 score of 259, and matched applicants averaging 8 research items, it’s a notable outlier: the highest Step 2 average of any specialty on this list paired with one of the lowest research averages.

7 | Vascular Surgery (66.7 Points)

Vascular surgery scores 66.7 points in 2026, up from 59.1 in 2024. Vascular surgeons treat diseases of the arteries, veins, and lymphatic system.

With a match rate of 85.7%, a Step 2 score of 256, and matched applicants averaging 26.5 research items, vascular surgery has seen one of the most dramatic research increases of any specialty, jumping from 12.8 items in 2024 to 26.5 in 2026, more than doubling. This data reflects the integrated track, in which applicants enter a combined program straight out of medical school rather than the traditional track, which first requires a general surgery residency. These figures reflect mean combined items consistent with prior years; the 2026 NRMP Charting Outcomes report now emphasizes median figures, but we continue to use the mean for consistency with our historical data.

Research averages are rising across every specialty, and vascular surgery is one of the starkest examples of how fast that bar can move. I worked tirelessly for only a handful of research items before medical school, and I saw firsthand how inefficient this was for me and so many of my peers. That’s why I developed a system that focused on results without eating up so much valuable time, ultimately accumulating over 60 research items by the time I applied to residency.

Together with Dr. Shaun Andersen and Dr. Deepal Patel, who also have over 60 publications, abstracts, and presentations each, we created The Ultimate Research Course for premed and medical students to help you skip the years of frustration and immediately implement strategies that actually work.

The students who’ve taken the course have dramatically increased their research output and matched into specialties they previously thought were out of reach.

6 | Otolaryngology/ENT (81.1 Points)

Otolaryngology, or ENT, scores 81.1 points in 2026, essentially unchanged from 80.7 in 2024. ENT surgeons manage conditions of the ears, nose, throat, and related structures of the head and neck.

With a match rate of 76.8%, a Step 2 score of 258, and matched applicants averaging 28.7 research items, ENT sits firmly in the “Very” competitive tier on SpecialtyRank.com. Though it ranks sixth this year, it’s been one of the most stable top-five fixtures over the past several cycles, and the research average continues to climb, up from 20.0 in 2024.

5 | Neurosurgery (82.4 Points)

Neurosurgery scores 82.4 points in 2026, down from 92.3 in 2024. Neurosurgeons surgically treat disorders of the brain, spine, and peripheral nerves.

The drop in points reflects shifts across the broader ranking landscape rather than neurosurgery becoming less demanding. With a match rate of 70.6%, a Step 2 score of 255, and matched applicants averaging 45.5 research items, the second highest of any specialty, neurosurgery demands nothing short of excellence. Neurosurgeons also command the highest average salary in medicine at $749,140, though the lifestyle reflects the stakes, with some of the most demanding hours of any specialty.

4 | Orthopedic Surgery (83.7 Points)

Orthopedic surgery scores 83.7 points in 2026, down from 88.4 in 2024. These surgeons treat injuries and diseases of the musculoskeletal system, including bones, joints, ligaments, tendons, and muscles.

With a match rate of 69%, a Step 2 score of 258, and matched applicants averaging 34.3 research items, orthopedic surgery remains one of the most demanding fields to match into. Over a third of matched applicants hold AOA status, reflecting just how competitive the applicant pool is.

3 | Dermatology (88.7 Points)

Dermatology scores 88.7 points in 2026, down from 94.1 in 2024, when it held the top spot. Dermatologists diagnose and treat conditions affecting the skin, hair, and nails.

With a match rate of 62.6%, a Step 2 score of 258, and matched applicants averaging 31.7 research items, dermatology’s position near the top is no surprise. Over 35% of matched applicants are AOA members. Dermatology also offers the rare combination of high compensation at $508,401 and an exceptional work-life balance, making it perennially competitive.

2 | Plastic Surgery (91.5 Points)

Plastic surgery climbs back to second with 91.5 points in 2026, rebounding from third in 2024 (88.6 points) after holding the top spot in 2022 (95.5 points). Plastic surgeons restore, reconstruct, and alter human body tissues through both reconstructive and aesthetic operations.

With a match rate of 65.4%, a Step 2 score of 258, and matched applicants averaging 50.8 research items, the bar is exceptionally high. Plastic surgery has seen the most dramatic increase in research averages of any specialty, jumping from 19.1 items in 2020 to 34.7 in 2024 to 50.8 in 2026. Back when I applied to plastic surgery residency in 2016, the average was just under 12, and even then I earned more than 60 publications, abstracts, and presentations, which helped me secure a residency seat in Southern California.

1 | Thoracic Surgery (95.9 Points)

Thoracic surgery claims the top spot for the first time, debuting on this list with 95.9 points in 2026. It’s also new to SpecialtyRank.com, where it now ranks first overall.

Thoracic surgery, also known as cardiothoracic surgery, covers the surgical treatment of organs inside the chest cavity, including the heart, lungs, aorta, esophagus, and diaphragm. These surgeons perform lung and heart transplants, valve replacements, coronary artery bypass grafts, and lung resections for cancer.

With only 56 positions offered in the 2026 match and 1,937 total applicants competing for them, it’s one of the smallest and most fiercely contested fields in medicine. Matched applicants averaged 34.8 research items, a Step 2 score of 259, and a match rate of 64%, reflecting a field where only the strongest candidates break through.

The lifestyle reflects the stakes of the work. A coronary artery bypass graft alone can run anywhere from 4 to 8 hours, and complications can push that to 12. Thoracic surgeons average $689,969 a year, but the work-life balance is among the most demanding in medicine.

Want to explore this data yourself? Visit SpecialtyRank.com to see the full rankings across all 24 specialties and customize the weightings based on what matters most to you.

2024 Most Competitive Specialties