Have you ever been confused when people talk about certain medical specialties being competitive? We meticulously calculated the most competitive specialties in medicine based on a wide selection of data across Step scores, match rate, publications, school funding, and more.
There’s a tremendous amount of misinformation out there regarding which medical specialties are competitive. Everyone wants to say their specialty is competitive—and they’re not wrong. Getting into any residency is a challenging ordeal. That being said, some specialties are more competitive and harder to get into than others.
There’s often a lot of pride involved, but whether or not your specialty is considered competitive does not make you a good or bad doctor. It simply says which specialties are hardest to get into. And knowing which specialties are hardest to get into can be very useful information for premeds and medical students. All specialties are competitive, and if your specialty is ranked lower than you’d like, that’s not a judgment at all—it’s simply what the data says.
This post will examine official statistics from the past decade and explore which are the most competitive and desired specialties. We’ll share the top 10 most competitive specialties, but you can view our complete spreadsheet to see where the other specialties ranked.
You can also take a look at our article (and video) on the Least Competitive Medical Specialties.
If you’d like to learn more about our methods and the data we used to reach our results, continue further into this article for a complete overview.
The Top Most Competitive Specialties in Medicine
Based on our comprehensive analysis, the top most competitive specialties are as follows:
- Plastic Surgery
- Orthopedic Surgery
- Interventional Radiology
- Radiation Oncology
- Vascular Surgery
- General Surgery
This ranking was determined by combining six categories of data that determine a specialty’s competitiveness. We utilized the latest US data from 2020, and we will update the list again once 2022 data becomes available.
- Match rank
- Step 1 score
- Step 2 CK score
- AOA percentage
- Top 40 NIH
What the Data Says
Dermatology came in first, trailed closely by plastic surgery in second. Neurosurgery was third, with a notable jump in total points. Next are orthopedic surgery in fourth and ENT in fifth.
In total, we examined 22 different specialties. The following chart shows the top 10 most competitive specialties based on data from 2020. Each category was given a ranking from 1 to 22, with 22 being the highest rank, and 1 being the lowest number of points awarded. These points were then added to reach a total number of points, which gives us our order of most competitive.
The specialty with the highest total points is plastic surgery, with a total of 120 points. Dermatology had the second highest point value at 116, and so on.
|Match Rate||Step 1 Score||Step 2CK Score||Publications||AOA percentage||Top 40 NIH||Total Points|
Let’s dig a little deeper into what makes the top five the most competitive.
1 | Plastic Surgery
Plastic surgery ranks as the most competitive specialty based on our comprehensive analysis, coming in at 120 total points. This specialty ranks quite high across all but one of our data categories. It places in the first, second, or third spot for all categories except Top 40 NIH, in which it places ninth overall.
Plastic surgeons focus on soft tissue, such as skin, muscle, and fat, as opposed to bones, which are in the territory of orthopedic surgeons. The word plastic comes from the Greek word “plastikos,“ meaning “to mold,” which is a reference to how plastic surgery reshapes and manipulates tissues.
If you are precise, meticulous, and have an obsession with details, plastic surgery may be a good fit for you. Plastic surgery is an innovative field where you’ll experience a ton of variety. Pay is more variable than other specialties, but you’ll still have quite a good lifestyle, as compensation is above average.
Learn more about the Plastic Surgery Specialty and if it’s the right fit for you.
2 | Dermatology
The dermatology specialty takes a jump down, coming in with a total of 116 points. This specialty is strong in each of our data categories with a slightly lower ranking for match rate.
Dermatologists manage diseases of the skin, hair, and nails, in both medical and procedural aspects. A dermatologist can identify and treat more than 3,000 conditions, including eczema, psoriasis, and skin cancer.
The dermatology specialty attracts a large number of medical students due to the excellent lifestyle and work-life balance that isn’t afforded by most other disciplines within medicine. Dermatologists are also highly compensated, usually ranking in the top 5 highest paid specialties in medicine, with an average salary of over $400,000 per year.
Learn more about the Dermatology Specialty and if it’s the right fit for you.
3 | Neurosurgery
The neurosurgery specialty ranks closely behind in third with 114 points. It ranks fairly high across all six categories. (This specialty is tied for third with ENT also coming in at 114 points.)
Neurological surgery focuses on the nervous system, which consists of two main components—the central nervous system (CNS) and the peripheral nervous system (PNS). CNS includes the brain and spinal cord, and PNS includes all other nerves within the body. Neurosurgery deals with surgical interventions of both CNS and PNS.
Neurosurgeons get to touch, change, and augment the central nervous system in real-time. Neurosurgery is one of the few specialties that can truly save people’s lives. Though it can be an exhilarating career, at a moment’s notice, you may be called into the hospital to save someone’s life. It’s a fascinating specialty that satisfies the intellectually curious, but it has one of the most challenging lifestyles of any specialty.
Learn more about the Neurosurgery Specialty and if it’s the right fit for you.
4 | ENT
In the fourth spot is the ENT specialty (Otorhinolaryngology), coming in at 114 points. This specialty ranks fairly high for all categories, with a high rank for Top 40 NIH, Step 2 CK score, and match rate. (This specialty is tied for third with Neurology also coming in at 114 points.)
ENT is a surgical subspecialty focused on diseases of the head and neck region. This includes the vocal cords and larynx, the nose and sinuses, ears, and endocrinology, including the thyroid and parathyroid, as well as head and neck cancers.
The lifestyle of an ENT is great, and you can make good money with a good balance in your life. This makes it an ideal specialty for those who want to be able to prioritize a family along with their career. It’s also one of the top paying specialties, averaging $450,000+ per year. The downside is that you deal with a very limited region of the body—one that is incredibly complex and difficult to navigate.
Learn more about the Otorhinolaryngologist (ENT) Specialty and if it’s the right fit for you.
5 | Orthopedic Surgery
Orthopedic surgery ranks in the number fifth spot with 104 total points. It ranks fairly high in all six categories, except for Top 40 NIH, in which orthopedic surgery ranks mid-range of 22 specialties.
Orthopedic surgery focuses on the musculoskeletal system, which includes fractures and broken bones. Surgeries also involve tendons, ligaments, and nerve or vascular injuries.
There’s notable satisfaction in being an orthopedic surgeon, as orthopedics usually have good outcomes. Most patients experience substantial improvement in their condition after surgery. Like many surgical specialties, orthopedic surgery can have challenging hours, but the trade off is that orthopedic surgeons are consistently the number 1 or number 2 highest compensated physicians.
Learn more about the Orthopedic Surgery Specialty and if it’s the right fit for you.
A Closer Look at Our Methods
Let’s take a closer look at the methodologies we used. The data is taken from the official source: the National Resident Matching Program (NRMP) for 2020. Data was inputted into a spreadsheet where ranks could be calculated and data could be shared transparently.
There’s always complaints about imperfect methodologies. Every analysis has its limitations, but compared to other lists, we take into account much more than just Step 1 scores and match rate.
I urge you to take a close look at the spreadsheet and play with the data to see for yourself. Before we dive in, it’s important to note that ophthalmology and urology are not included in the regular match, and therefore, their data was not included in this analysis. That being said, if you look up their average Step scores and match rates, it’s clear neither would have been in the top five anyway.
Data was analyzed for US applicants only, as incorporating international medical graduates (IMGs) would muddy the analysis. The analysis goes far beyond match rate, as that would be a terribly simplified and inaccurate marker of competitiveness.
Now, you might be confused. If a specialty has a low match rate, then it must be more competitive, right? Not exactly. Specialties are self-selecting. I recently saw an analysis by someone who went only by match rates alone, and in doing so, they suggested that general surgery and psychiatry were the third most competitive specialties. Anyone who is in medical school or residency will tell you that’s certainly not the case.
For example, in plastic surgery, applicants use general surgery as their backup in case they don’t get into plastics. Look at it this way: if you’re not a competitive applicant, you’re not going to apply to something like plastic surgery or neurosurgery. Lots of people want to do surgery, and general surgery is the most commonly applied to. General surgery is tremendously broad and diverse, leaving options open to subspecialize after, and it’s the least competitive of the surgical specialties. Hence the high number of applicants and the low match rate.
This is not a judgment against general surgery. This is simply an explanation for its low match rate. Again, please view the data in the spreadsheet to see how it compares once multiple data categories are examined.
In order to overcome the shortcomings of looking at match rate alone, we examined six categories of data: match rate, Step 1 score, Step 2 CK score, number of publications, percentage of matriculants that were AOA, and percentage of applicants from a top 40 NIH-funded medical school.
AOA, or the Alpha Omega Alpha Honor Medical Society, is an honor society in medicine. What you need to know for the purposes of this analysis is that being AOA is a good indicator of being a high-performing student. Obviously it’s not perfect, as some schools don’t have it.
Top 40 NIH-funded medical schools are usually more competitive, meaning students who got into these schools were, on average, stronger students. Emphasis on the world average.
Each specialty was ranked in each of the six categories. This was a points-based ranking system. Each category was weighted equally and points were awarded directly in relation to the ranking. Meaning, there are 22 specialties; the lowest ranking in that category would receive 1 point, and the top ranking in that category would receive 22 points.
Points were added across each category for a point total to determine which specialties were most competitive.
I’m not surprised by these results—and that’s a good sign. If you’re a medical student or resident, you probably aren’t surprised either. But many people have heard of the ROAD to success. ROAD stands for Radiology, Ophthalmology, Anesthesiology, and Dermatology.
If you’re surprised that the other three ROAD specialties aren’t included in the top 5, don’t be. Radiology, Ophtho, and Anesthesia are not nearly as competitive as the top 5. ROAD specialties indicate those that have a great lifestyle, not necessarily which are the most competitive.
Want to learn more? Here’s Why Some Specialties are More Competitive than others.
An interesting pattern I noticed was that the top 5 were all very well-paid specialties. Neurosurgery and orthopedic surgery are almost always the top 2 best-paid specialties, regardless of the survey. Plastic surgery is also up there, but it’s important to note that cosmetic practices make much more than reconstructive practices. Dermatologists don’t make as much as the other top 4 specialties, all of which are surgical, and that makes sense. Surgeons put in more work and do more challenging procedures, but dermatologists have a lifestyle that’s hard to beat.
What do you think of the results? Are you surprised, or is this what you were expecting? Leave a comment down below—We’d love to hear your thoughts.
So, what’s the conclusion to all of this? It’s quite clear that the most competitive specialties are highly correlated with either excellent pay or excellent lifestyle. Correlation is not causation, but I think it’s safe to say that there’s more than a simple correlation going on here.
Every analysis has its limitations. That being said, we took careful care to craft a comprehensive analysis of multiple factors that contribute to a specialty’s competitiveness. We’ll continue to update the overall analysis spreadsheet to reflect the most recent data available.
How to Choose a Specialty
If you’re not sure what specialty you want to pursue, we have a whole series dedicated to dissecting different specialties and subspecialties. Our “So You Want to Be…” series takes a deep dive into how to pursue each specialty, pros and cons, and how to determine if the specialty will be a good fit for you.
Some recent specialties we’ve covered include:
- So You Want to Be an Interventional Cardiologist
- So You Want To Be an Oral and Maxillofacial Surgeon
- So You Want to Be an Endocrinologist
- So You Want To Be a General Surgeon
- So You Want to Be a Podiatrist
Do You Want to Pursue a Competitive Specialty?
If you’re aiming for a highly-competitive specialty, we can get you there. Med School Insiders offers a range of multimedia courses designed to help you reach your potential.
Each course was created by our team of top performing doctors. The Premed Roadmap will help you get accepted to a Top 40 NIH medical school, and the interview courses for medical school or residency are hands down the most comprehensive and high-yield guides on the interview process that you’ll find anywhere. Even better, both are constantly being updated and improved with new exclusive videos, written content, and private group mentorship access.
If you’re about to apply to residency, check out our Comprehensive Residency Match Packages, which include essay editing, application editing, interview preparation, research advice, and more.