Top 5 Most Competitive Specialties in Medicine

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Have you ever been confused when people talk about certain medical specialties being competitive? Me too. In this video, we’ll go over the official statistics and explore which are the most competitive and desired specialties.

There’s a tremendous amount of misinformation 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. I understand the 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 pre-meds and medical students. Again, all specialties are competitive, and if your specialty is ranked lower than you’d like, that’s not a judgment or an attack on you in any way. This is simply the data. Period. You can find the data links in the description. 

 

Methods

First, let’s cover the methodologies I used. I gathered all data from the official source – the NRMP, or the National Resident Matching Program, over the past few years. I manually inputted all data into a spreadsheet that I’ve linked in the description for you to view. There’s always someone complaining about imperfect methodologies – look, every analysis has its limitations. I urge you to view 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 5 anyway. 

I used data for U.S. applicants only, as incorporating international medical graduates, or IMGs, would muddy the analysis. I looked beyond just the match rate, as that would be a terribly inaccurate marker of competitiveness. Now you’re probably confused. If it has a low match rate, then it must be more competitive, right? Not exactly. Specialties are self-selecting. I recently saw a video by someone who went only off of match rates, 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, since surgery is freakin’ awesome, and general surgery is the most commonly applied to. General surgery is tremendously broad and diverse, leaves options open to subspecialize after, and is 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 the low match rate in general surgery. Again, please view the data in the spreadsheet.

In order to overcome the shortcomings of looking at match rate alone, I examined six categories of data: average 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. For example, mine didn’t, and therefore I wasn’t AOA, despite being at the top of my class. Top 40 NIH funded medical schools are usually more competitive, meaning students that got into these schools were, on average, stronger students. Emphasis on average. 

After averaging the data, I ranked each specialty 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, and the lowest ranking in that category would receive 1 point and the top ranking in that category would receive 22 points. I summed up the points across each category and looked at the total points to determine which specialties were most competitive.

Now’s your chance to hedge your bets. Drum roll, please.

 

Results

 

Dermatology came in first, trailed closely by plastic surgery in second. Neurosurgery was third, followed by orthopedic surgery fourth and then ENT in fifth.

 

Discussion

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. 

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.

So the conclusion of all 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 simple correlation going on here. Exploring this finding is a topic for another video.

 Was this analysis perfect? Absolutely not – again, every analysis has limitations. That being said, this is the most comprehensive one I’ve seen.

 

Conclusion

What do you think of the results? Are you surprised, or is this what you were expecting? Leave a comment down below – I’d love to hear your thoughts. 

If you’re aiming for a highly competitive specialty, check out the all-new multimedia courses on MedSchoolInsiders.com. Each course was created by our team of top doctors. The Pre-Med 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 interviews 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. They’re on sale right now for a limited time. Link in the description.

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