Explore the 10 Most Competitive Medical Specialties

Deciding on a medical specialty is one of the most important and challenging decisions for aspiring doctors. Among the numerous options, the most competitive medical specialties stand out due to their high demand, rigorous requirements, and significant rewards. Although these fields demand exceptional academic performance and extensive training, they also promise substantial financial benefits and career growth opportunities. 

Whether you’re drawn to the intricate procedures of surgery or the complex diagnostics in radiology, understanding the most competitive medical specialties can help you make an informed decision about your future. So, read along as we explore the top in-demand specialties. Discover what makes them so competitive and why they attract the best and brightest in the medical field. 

How Competitiveness Is Measured and Ranked in Medical Specialties

When it comes to choosing a medical specialty, understanding the competitiveness of each field is essential. Several key metrics can help you gauge this, including:

• Match rates
• The United States Medical Licensing Examination (USMLE) Step 2 Clinical Knowledge (CK) scores
• Average annual salaries

Firstly, match rates show the percentage of applicants who successfully secure positions in a particular specialty, reflecting how in-demand that specialty is. By considering the number of applicants per position, you get a sense of the competition level—how many candidates are vying for each available spot. A specialty with more positions may appear less competitive, but this isn’t always the case if the number of applicants is proportionally high.

USMLE Step 2 CK scores are another important metric. These scores highlight the academic rigor required for each specialty. Generally, the higher the average score, the more competitive the specialty is, as only the top-performing students are likely to be successful.

Finally, average annual salaries reveal much about a specialty’s competitiveness. Specialties that offer higher salaries tend to attract more applicants, making them more competitive. High earning potential is a significant draw, leading to a greater number of candidates striving for a limited number of positions.

Most Competitive Medical Specialties

Let’s explore together the ten most competitive medical specialties.

Dermatology

Dermatology is a medical specialty focused on diagnosing and treating skin, hair, and nail conditions. Dermatologists complete medical school, followed by a one-year internship and a three-year dermatology residency.

This specialty is important because the skin is the body’s largest organ and reflects overall health. As such, dermatologists treat a wide range of issues, from acne and eczema to skin cancer, contributing to skin health.

• Match Rate: 10,1%
• Number of Applicants: 295
• Total Positions Offered: 30
• Average USMLE Step 2 CK Score: 257
• Average Salary: 342,860 per year

Plastic surgery

Plastic surgeons focus on reconstructing and enhancing physical appearance and function through procedures like rhinoplasty, facelift, and other corrective surgeries. Their work aims to make people confident in their skin, free of any health implications or flaws. 

Plastic surgery requirements include completing medical school, a residency in general surgery, and a fellowship in plastic surgery. 

• Match Rate: 58.8%
• Number of Applicants: 362
• Total Positions Offered: 213
• Average USMLE Step 2 CK Score: 257
• Average Salary: $192,800 per year

Neurosurgery

Another highly competitive specialty is neurosurgery, treating disorders affecting the brain, spine, and nervous system. This field is highly significant due to its role in treating life-threatening conditions like brain tumors, spinal cord injuries, and aneurysms, having a profound impact on patient lives.

The competitiveness of neurosurgery stems from the complexity of procedures, the high level of expertise needed, and the rigorous educational path, which includes medical school, a 5-6 year residency, and often additional specialized fellowships. 

• Match Rate: 56.9%
• Number of Applicants: 423
• Total Positions Offered: 241
• Average USMLE Step 2 CK Score: 252
• Average Salary: $299,083 per year 

Orthopedic surgery

Orthopedic surgeons specialize in diagnosing and treating musculoskeletal system conditions, including bones, joints, muscles, ligaments, and tendons. They treat conditions like fractures, arthritis, and sports injuries, which are vital for maintaining mobility and quality of life. 

The demanding nature of orthopedic procedures and the need for precision and skill make this specialty highly sought after.

• Match Rate: 61.3%
• Number of Applicants: 1,492
• Total Positions Offered: 915
• Average USMLE Step 2 CK Score: 256
• Average Salary: $236,650 per year 

Otolaryngology (ENT)

Otolaryngologists help patients dealing with ear, nose, and throat (ENT) conditions. They are experts in nasal cavity care, sinuses, larynx disease, and other infectious diseases in the head and neck areas. 

This specialty requires completing medical school and five years of residency training, making it a competitive field due to the broad range of conditions treated and the expertise required.

• Match Rate: 74.2%
• Number of Applicants: 513
• Total Positions Offered: 382
• Average USMLE Step 2 CK Score: 257
• Average Salary: $200,674 per year 

Interventional radiology

Interventional radiology is another competitive medical specialty that uses imaging techniques like X-rays, CT scans, and MRIs to guide minimally invasive procedures. Professionals in this field treat various conditions, such as blocked blood vessels, tumors, and spinal fractures, without the need for major surgery.

This specialty is significant because it often results in less pain, shorter recovery times, and lower risk compared to traditional surgery. 

• Match Rate: 17,1%
• Number of Applicants: 293
• Total Positions Offered: 50
• Average USMLE Step 2 CK Score: 253
• Average Salary: $181,519 per year

Thoracic & cardiac surgery

Thoracic and cardiac surgery is the surgical treatment of chest-related diseases, including heart, lung, and esophageal conditions. This field is vital for managing severe health issues such as heart disease, lung cancer, and esophageal disorders.

Surgeons in this specialty perform intricate operations like heart bypasses, valve repairs, and lung surgeries, which demand extreme precision and expertise.

• Match Rate: 42.1%
• Number of Applicants: 114
• Total Positions Offered: 48
• Average USMLE Step 2 CK Score: N/A
• Average Salary: $219,862 per year

Ophthalmology

Ophthalmologists focus on the medical and surgical care of the eyes and vision, treating eye diseases, performing eye surgeries, and prescribing corrective lenses, which can significantly impact a person’s quality of life. This specialty is known for its blend of medical and surgical expertise and the ability to dramatically improve or restore vision, making it a vital field in healthcare.

Ophthalmologists are on the higher end of the scale in terms of salary expectations, which contributes to its competitiveness. 

• Match Rate: 66%
• Number of Applicants: 917
• Total Positions Offered: 518
• Average USMLE Step 2 CK Score: N/A
• Average Salary: $312,210 per year

Vascular surgery

The vascular system—which includes arteries, veins, and lymphatic circulation—is an intricate body system that is well taken care of through vascular surgery. This field is unique because it involves both surgical and minimally invasive techniques to manage complex conditions such as aneurysms, blood clots, and peripheral artery disease.

The specialty is highly sought after due to its critical role in preventing life-threatening complications and improving patient outcomes. 

• Match Rate: 60.7%
• Number of Applicants: 163
• Total Positions Offered: 99
• Average USMLE Step 2 CK Score: 250
• Average Salary: $258,790 per year

Radiation oncology

Radiation oncologists are heroes of cancer treatment. Using radiation therapy, these healthcare providers develop and administer radiation treatments to target and destroy cancer cells while minimizing damage. This field is crucial for cancer care and is often used in conjunction with surgery and chemotherapy to improve survival rates and quality of life. 

Becoming a radiation oncologist requires completing medical school, a residency in radiation oncology, and often additional fellowship training for sub-specialization. 

• Match Rate: 9.02%
• Number of Applicants: 133
• Total Positions Offered: 12
• Average USMLE Step 2 CK Score: 249
• Average Salary: $258,751 per year

Which Specialty Should I Choose?

Prospective students must consider various factors when deciding on their specialty. Factors like match rates, educational and training requirements, and financial rewards collectively contribute to competitiveness among medical specialties. 

Beyond competitiveness and salary expectations, students should prioritize personal preferences when making a decision, as they are crucial for long-term satisfaction. Lifestyle considerations, such as work-life balance and job location, also play a significant role. In addition, career goals, including the desire to perform surgeries or engage in patient care, should align with the chosen specialty. And lastly, the current job market demand is vital for job security and opportunities after training. 

Balancing these factors will guide students toward a fulfilling medical career and ensure overall job satisfaction.

The Bottom Line

While some medical specialties are more competitive and challenging to secure than others, they also offer immense rewards and opportunities. Remember, with dedication and hard work, you can be the one securing that coveted match, successfully passing the MCAT, and ultimately benefiting from the rewarding salaries associated with any medical specialty.

No matter how small the percentage of acceptance may be, your commitment and perseverance can lead you to a fulfilling and successful career in medicine.

Frequently Asked Questions (FAQs)

Which medical specialty has the highest demand?

According to BLS data, psychiatry is among the specialties with the highest demand, as employment of psychiatrists is expected to increase by 7% throughout the decade.

What are the least competitive residencies?

Family medicine and pediatrics are among the least competitive residencies. 

What if I am an International Medical Graduate (IMG) applying for residency in the United States?

IMGs should focus on achieving high USMLE scores, gaining U.S. clinical experience, and applying to IMG-friendly programs to improve their chances of matching into a residency.