Top 10 Least Competitive Specialties in Medicine

Choosing a specialty is one of the most important decisions any future doctor makes, and there’s no guarantee of matching into the one you want. Knowing where the bar actually sits for less competitive fields can be just as useful as knowing which ones are hardest to crack.

In a previous article, we covered the top 10 most competitive specialties to match into. This post covers the other end of the list.

Using brand new 2026 NRMP Charting Outcomes data, we reassessed the least competitive specialties in medicine across 24 fields, ranking them by Step 2 CK scores, match rates, research items, school funding, and more. For the complete rankings across all 24 specialties, visit SpecialtyRank.com.

The 10 Least Competitive Specialties in Medicine

These are the 10 least competitive specialties to match into based on 2026 data:

1. Family Medicine
2. Pediatrics
3. Emergency Medicine
4. Psychiatry
5. Child Neurology
6. Pathology
7. Internal Medicine
8. Neurology
9. PM&R
10. OB/GYN

SpecialtyRank.com determines competitiveness by combining five categories of data: USMLE Step 2 CK scores, match rate, research items, AOA percentage, and top 40 NIH funding. The weighted breakdowns are as follows.

• Step 2 CK Score: 30%
• Match Rate: 30%
• Research Items: 30%
• AOA: 5%
• Top 40 NIH: 5%

Want to see how your stats stack up? Head to SpecialtyRank.com for detailed specialty rankings and competitiveness metrics across all 24 specialties.

5 | Child Neurology

Child neurology comes in fifth with 28.5 points in 2026, down from 34.3 points in both 2024 and 2022. 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 is a specialized niche with consistently low competitiveness. The drop in total points reflects the broader landscape shifting around it rather than the specialty itself becoming easier to enter.

4 | Psychiatry

Psychiatry ranks fourth with 22.2 points in 2026, up slightly from 20.9 in 2022 but down from 25.2 in 2024. It consistently sits near the bottom of the competitiveness rankings across every cycle we’ve tracked.

With a Step 2 score of 246, a match rate of 93.3%, and an average of 9.8 research items, psychiatry has one of the lowest bars to entry of any specialty in medicine. Psychiatrists also tend to enjoy a healthy work-life balance, averaging $341,977 a year.

If you’re having trouble deciding what specialty you want to pursue, our So You Want to Be playlist takes a deep dive into the pros, cons, and training steps for every medical specialty.

3 | Emergency Medicine

Emergency medicine ranks third with 15.2 points in 2026, relatively stable compared to 15.0 in 2024 but down from 20.0 in 2022. It’s one of the most consistent fixtures near the bottom of the competitiveness rankings.

With a Step 2 score of 248, a match rate of 96.3%, and an average of 8.3 research items, the bar to entry is low relative to most specialties. That said, the work itself is anything but easy. Emergency medicine physicians spend their shifts on the front line of healthcare, managing high-intensity, unpredictable situations around the clock, and the specialty has some of the highest burnout rates in medicine. EM physicians average $411,133 a year and typically work shift-based schedules, usually three to four days a week.

2 | Pediatrics

Pediatrics ranks second with 13.3 points in 2026, essentially unchanged from 13.4 in 2024 and 14.1 in 2022. It’s one of the most stable fixtures near the bottom of the competitiveness rankings.

With a match rate of 99.4%, a Step 2 score of 249, and an average of 8.5 research items, pediatrics has one of the most accessible paths to matching in all of medicine. The average pediatrician earns $265,230 a year, which is at the lower end of physician compensation, and the gap between competitiveness and pay reflects a pattern seen across primary care specialties.

Research items consistently play a huge role in a candidate’s ability to match into their desired program, no matter how competitive it is. The Med School Insiders Ultimate Research Course distills the tactics the fellow course creators and I used to gain over 60 research items each. You’ll learn to publish more in less time, build a research team around you, confidently present your work, and so much more, including advanced tactics you won’t find anywhere else because we innovated them.

The course includes over 75 video modules, templates, and resources, as well as an exclusive private community to help you elevate your research to the highest level. We’re so confident you’ll find tremendous value that it comes with a 10-day money-back guarantee.

1 | Family Medicine

Family medicine holds the least competitive spot with 6.1 points in 2026, down from 7.3 in 2024 and 11.1 in 2022. No specialty has come close to displacing it from the bottom of the rankings across any cycle we’ve tracked.

With a Step 2 score of 244, a match rate of 99.1%, and an average of 6.7 research items, family medicine has the lowest bar to entry of any specialty in medicine by a considerable margin. Family physicians are the generalists of generalists, seeing the full spectrum of patients across all age groups and conditions rather than focusing on a single organ system or disease.

Family medicine physicians typically work regular business hours with minimal call, averaging $318,959 a year. The gap between that figure and what more competitive specialties pay reflects how much medicine rewards specialization, but for physicians drawn to comprehensive, long-term patient relationships, family medicine offers something most specialties don’t.

Understanding the Data

Overall, the least competitive specialties moved less dramatically in 2026 than the most competitive ones did.

Family medicine and pediatrics held their spots at the bottom of the rankings. Emergency medicine dropped from third to second in 2024, then returned to third in 2026, while psychiatry moved in the opposite direction. The bigger shift further up the least-competitive list is the addition of OB/GYN to the bottom 10, replacing radiation oncology, which drops out of the bottom 10 entirely in 2026.

Unlike the most competitive specialties, there’s far less correlation between pay and competitiveness rank on this list. Family medicine and pediatrics are among the lowest-paid specialties, but emergency medicine, pathology, and psychiatry aren’t anywhere near the bottom of physician compensation, despite ranking near the bottom in competitiveness.

One trend showing no sign of slowing is the rising average number of research items across all specialties, including the least competitive ones. Family medicine moved from 4.2 in 2024 to 6.7 in 2026. Pediatrics went from 6.9 to 8.5. Even at the least competitive end of the spectrum, the bar keeps moving. These figures reflect mean combined items consistent with prior years; the 2026 NRMP Charting Outcomes report now emphasizes medians, but we continue to use the mean for consistency with our historical data.

Every analysis has its limitations, and this one is no exception. We’ve carefully weighed multiple factors to build a comprehensive picture, but the data is a starting point, not the whole story. Just because a specialty sits at the bottom of this list doesn’t mean it’s easy to get into. Every specialty in medicine is competitive. Some are just more so than others.

For a deeper look at what drives these differences, check out Why Some Specialties Are More Competitive Than Others.

Results From 2024

Find Your Best-Fit Specialty

The right specialty balances your interests, lifestyle goals, and the likelihood of a realistic match given your actual credentials. Competitiveness rankings are a useful starting point, but they don’t tell you where you personally stand.

SpecialtyPredictor.com uses your Step scores, research experience, and other application factors to show you realistic match probabilities across all specialties. You’ll see where you’re competitive, where you might be reaching, and where you have safety options, all based on real NRMP data. It’s the insight you need to build a smart rank list and maximize your chances of matching into a program you’ll love.