Updated 2022: Top 10 Least Competitive Specialties in Medicine | Med School Insiders (2023)

Choosing a specialty is one of the most important decisions that any future doctor makes, and even then, there’s no guarantee of matching into your desired specialty. So, what specialties have the least competition? We meticulously calculated the least competitive specialties in medicine based on a wide selection of data across Step scores, match rate, publications, school funding, and more.

In a previous article, we covered the Top 10 Most Competitive Specialties to match into, so be sure to check out that post too.

Matching into residency is arguably more competitive now than it has ever been. During the most recent 2022 NRMP Match, there were approximately 6,400 medical students who applied for residency and went unmatched—even after the Supplemental Offer and Acceptance Program, or SOAP. For some perspective, that’s approximately 15% of the total number of active applicants in 2022.

If you don’t match or are worried about matching, read our SOAP Match Guide.

If your dream is to match into a competitive specialty, such as plastics, ENT, or dermatology, there is a very real chance that you won’t match. As such, your life becomes much easier if you apply to a less competitive specialty.

We’ll be using the same methods we used in our previous examination of the top most competitive specialties. We’re taking into account the match rate, average Step 1 score, Step 2CK score, number of publications, percentage of matriculants who are AOA, and percentage of students from a top 40 NIH-funded medical school. Just like with the previous analysis, we also added an additional weighting to each of the categories to better reflect their importance in residency admissions.

The 10 Least Competitive Specialties in Medicine

The following medical specialties are those that ranked the lowest and are, therefore, the easiest to match into, relatively speaking. 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.

With that said, here are the 10 least competitive specialties to match into:

1. Family Medicine
2. Pediatrics
3. Psychiatry
4. Emergency Medicine
5. Physical Medicine & Rehabilitation
6. Neurology
7. Child Neurology
8. Pathology
9. Internal Medicine
10. Anesthesiology

This ranking was determined by combining six categories of data that determine a specialty’s competitiveness. We utilized the latest US data from 2022, and we will update the list again as soon as new data becomes available in future years.

• Match rank
• Step 1 score
• Step 2 CK score
• Publications
• AOA percentage
• Top 40 NIH

What the Data Says

We gathered data from the National Residency Matching Program (NRMP), examining six categories for each specialty: 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 often a good indicator of being a high-performing student. That being said, it’s not perfect, as many schools don’t have it. The top 40 NIH-funded medical schools are usually more competitive, meaning students who got into these schools were, on average, stronger students.

Using this data, we ranked each specialty from 1 to 24 in each category, with 1 being the specialty with the lowest score in that category and 24 being the specialty with the highest score. We then added up all of the points to determine the specialty’s competitiveness.

Every analysis has its weaknesses, and this is no exception. The main limitation is that it weighs each of the six components equally. In reality, some components are more indicative of a specialty’s competitiveness than others. To help address this shortcoming, we created the new 2022 MSI Competitiveness Index, which weights each of the six components based on their relative importance. Match rate is weighted 25%, Step 1 score 25%, Step 2 CK score 15%, publications 20%, AOA 10%, and Top 40 NIH School 5% to better reflect the relative importance of each component.

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. It should be noted that, given the lack of complete data, ophthalmology was not included in this analysis.

If you want to check the data yourself, we have an entire spreadsheet that contains all of our calculations.

1 | Family Medicine

The number one least competitive specialty is family medicine with a total of 10 points. This specialty has held this spot for quite a few years now.

Family medicine is the center of primary care. These are the generalists of generalists. Unlike other specialties that focus on a particular organ, disease, or age range, family medicine physicians see the full spectrum of patients—from young to old, healthy to unhealthy, and everything in between.

To become a family medicine physician, you must complete three years of family medicine residency after medical school.

Family medicine has a lot to offer relative to other specialties. First off, you have a great deal of flexibility within family medicine. If you want to deliver babies all day, you can do that. If you want to practice in the emergency department, you can do that too. Or maybe you want to practice inpatient as a hospitalist. All these and more are possible with family medicine.

Family medicine physicians also have desirable schedules, usually working regular 9 to 5 business hours with minimal, if any, call. They also have amazing access to longitudinal care and can see patients from the time that they’re born through adulthood.

In terms of compensation, family medicine doctors have an average annual salary of $236,000 and work an average of 53 hours per week.

Learn more about the Family Medicine Specialty and whether or not it’s the right fit for you.

2 | Pediatrics

Number two on our list is pediatrics with a total of 14 points.

Pediatrics is the field of medicine providing care for babies, children, and adolescents from birth up to the age of 25.

After medical school, pediatrics residency is 3 years in duration, after which you’ll have several options for subspecialization, including pediatric hematology/oncology, cardiology, and gastroenterology, to name a few.

Pediatrics is a unique field in that you get to make an impact early in your patient’s life that can compound to yield tremendous changes over a long period. It can be considered one of the most powerful forms of preventive medicine.

Although pediatrics is consistently one of the lowest paid medical specialties, at around $244,000 per year, there’s a high amount of flexibility in the field. After all, these are the doctors who prioritize children. Even in residency, your program will often be more understanding of things like maternity or paternity leave than most other specialties.

Learn more about the Pediatrics Specialty and whether or not it’s the right fit for you.

3 | Psychiatry

Number three is psychiatry with a total of 18 points, putting it as 22nd in competitiveness.

Psychiatry is the field of medicine focused on understanding and treating mental health disorders and psychological distress.

After medical school, psychiatry residency is 4 years in duration.

If you enjoy spending time with patients, psychiatry is one of the few specialties where you can regularly have 45-60 minute appointments. You’ll also have the opportunity to see your patients develop and improve with time, which can be incredibly gratifying.

Psychiatrists also often enjoy a lifestyle that’s hard to beat. The average psychiatrist earns $287,000 and works an average of 47 hours per week.

Psychiatry isn’t without its drawbacks, however. Due to the nature of treating mental illness, psychiatry can often be incredibly emotionally draining. In addition, psychiatrists often deal with difficult patient populations, such as those with substance use disorders, severe mental illness, or personality disorders that can be challenging to manage.

Learn more about the Psychiatric Specialty to find out if it’s the right fit for you.

4 | Emergency Medicine

Number four on our list, and the 21st most competitive specialty out of 24, is emergency medicine with a total of 19 points.

Emergency medicine is the specialty concerned with treating patients who are acutely ill with urgent healthcare needs. This includes treating acute conditions like myocardial infarctions, heart attacks, exacerbations of chronic health conditions, stabilizing patients involved in trauma, and more.

Emergency medicine residency varies from 3 to 4 years in duration, depending on the program. To learn more about the pros and cons of each type of program, be sure to check out our So You Want to Be an Emergency Medicine Doctor video.

In terms of lifestyle, EM doctors typically work 3-4 days per week and have the remainder of the week off. They also tend to do shift work, meaning they clock in and out and don’t take work home with them. The average EM physician works around 46 hours per week and earns approximately $373,000 per year.

That being said, emergency medicine physicians experience some of the highest rates of burnout. Some contributing factors include working on the front line, consistently high intensity, stress, unpredictability, the increasing time required for charting at the expense of patient interaction, and irregular circadian rhythm. There’s also a fear of litigation looming over your head given the higher rates of malpractice claims compared to the average physician.

Learn more about the Emergency Medicine Specialty and whether or not it’s the right fit for you.

5 | Physical Medicine & Rehabilitation

Number five is physical medicine and rehabilitation, or PM&R, with a total of 21 points. This places the specialty at 20th in terms of competitiveness.

PM&R is the jack-of-all-trades specialty, focusing on both inpatient and outpatient management of non-operative orthopedics and neuro-rehabilitation. These are the primary physicians for certain nervous system and non-surgical orthopedic disorders, offering both medical and procedural treatment modalities.

After medical school, PM&R residency is 4 years long.

One of the advantages of PM&R is that it is heavily team-focused. You have the opportunity to work with PTs, OTs, and speech therapists on a regular basis, in addition to case management and liaisons to help coordinate care.

The lifestyle is generally favorable as well, with the average PM&R physician earning $322,000 per year and working an average of 45 hours per week.

That being said, PM&R is slower-paced and requires a great deal of patience. You have to be able to enjoy the small victories and endure the ups and downs of treatment and management, as patients aren’t generally getting back to 100% of their baseline functional status.

Find out if the Physical Medicine and Rehabilitation Specialty is right for you.

6 | Neurology

Number six on our list and the 19th in competitiveness is neurology with a total of 29 points.

Neurologists are physicians who specialize in the non-surgical management of a variety of central and peripheral nervous system disorders. They manage everything from headaches and migraines to the most devastating and incurable diseases, such as amyotrophic lateral sclerosis, or ALS, and Hungtington’s disease. Strokes, which are the fifth leading cause of death and first leading cause of disability in the US, are also diagnosed and treated by neurologists.

To become a neurologist, you must complete 4 years of neurology residency.

In terms of lifestyle, about 80% of neurology is outpatient. This means that you are less likely to work weekends, and more likely to have a regular 8-5 practice. It should be noted, however, that most private practice neurologists do have to take call for local hospitals.

Neurology is also in the lower third of specialties with regards to compensation at $301,000 per year. This is in large part because neurologists deal with primarily chronic illnesses and there are fewer procedures in neurology compared to other specialties.

Considering neurology? Learn more about the Neurology Specialty to find out if it’s the right fit for you.

7 | Child Neurology

Number seven on our list and the 18th in competitiveness is child neurology with a total of 30 points.

Child neurology is the field of medicine focusing on disorders of the brain, spinal cord, and peripheral nerve and muscle affecting infants, children and adolescents.

To become a child neurologist, you must complete 5 years of residency training after medical school. This is broken down into 2 years of general pediatrics followed by three years of pediatric neurology.

Child neurology is an incredibly rewarding field. You have the opportunity to help children through a variety of neurological conditions and see them improve over time. In addition, some of the most common conditions you encounter as a child neurologist, such as epilepsy and headache disorders, can resolve on their own as a patient ages.

That being said, as a child neurologist, you will also see a variety of neurodegenerative diseases and cancers with poor prognoses. This can weigh heavily on patients, families, and physicians, as delivering bad news to the patient and their family is not uncommon. These conversations are always difficult—no matter how experienced of a physician you are.

In terms of compensation, child neurologists make an average of $253,000 per year.

8 | Pathology

Number eight on our list and the 17th in competitiveness is pathology with a total of 31 points.

Pathology is the field of medicine concerned with the study of body tissues and body fluids. They examine specimens to give tissue diagnoses as well as manage all of the clinical labs ordered by other physicians—from microbiology to hematology to chemistry, and everything in between.

To become a pathologist, you must complete 3-4 years of residency after medical school, depending on which pathway you choose. The majority of pathology residents complete combined anatomical and clinical pathology residency, which is four years long; however, there are separate anatomic and clinical residency programs as well, which are three years long.

Pathology is known for having a great lifestyle, with the average pathologist making approximately $334,000 per year and working an average of 47 hours per week.

If you don’t enjoy hands-on patient care, you can also take comfort in knowing that pathologists spend much of their time in the lab reviewing specimens and have very limited interaction with patients.

With that in mind, some pathologists do end up missing the patient care aspect of being a physician. In addition, advancements in artificial intelligence and machine learning are likely to have a significant impact on the field in the coming years. Although it is unlikely that computers and algorithms will replace pathologists, they will likely have a profound effect on the way that pathologists work—and nobody knows what the downstream effects will be.

Find out if the Pathology Specialty is the right fit for you.

9 | Internal Medicine

Number nine on our list and the 16th most competitive specialty is internal medicine with a total of 37 points.

Internal medicine is the specialty that deals with the diagnosis, treatment, and prevention of a broad and extensive number of diseases that affect adult patients. It is also the gateway to fellowship in a variety of fields, including cardiology, gastroenterology, oncology, and nephrology, to name a few.

After medical school, internal medicine residency is 3 years.

As a specialty, internal medicine offers tremendous flexibility. If you want to work as a hospitalist, taking care of admitted patients, you can do that straight after IM residency. If you want to do primary care in an outpatient clinic, that’s common too. If you’d like to specialize and further your interest with something more focused like cardiology or gastroenterology, there’s a clear path for that as well.

The lifestyle of an internist is also generally favorable. As a hospitalist, the 1 week on/1 week off model is very common, and outpatient internists often work regular business hours 5 days a week.

That being said, IM is in the bottom quartile of compensation. The average internal medicine doctor earns approximately $264,000 per year and works an average of 55 hours per week. In addition, administrative tasks, such as charting and computer work, often take up a much larger portion of an internal medicine physician’s day compared to other specialties.

Is internal medicine the right fit for you? Learn more about the Internal Medicine Specialty.

10 | Anesthesiology

Lastly, number ten on our list is anesthesiology with a total of 40 points. This is the 15th most competitive specialty out of the 24 specialties used in our analysis.

Anesthesiology is the field of medicine concerned with taking care of patients before, during, and after surgery. Think of them as the “guardian angel” that ensures patients get through surgery safely.

To become an anesthesiologist, you must complete 4 years of anesthesia residency after medical school.

Being one of the ROAD specialties, anesthesiology is known for having a great lifestyle, meaning high compensation and great work-life balance. The average anesthesiologist earns $405,000/year and works around 40-50 hours per week.

That being said, anesthesiology can also be incredibly stressful. Things can and will go wrong during surgery, and the patient’s life will be in your hands. In addition, midlevel encroachment from CRNAs is also a growing concern.

To learn more about the issue of midlevel encroachment, be sure to check out our article: PA and NP vs MD and DO.

Learn more about the Anesthesiology Specialty and whether or not it’s the right fit for you.

Final Thoughts

Were you surprised by any of the specialties on this list? Let us know with a comment below.

Every analysis has its limitations. That said, we took careful care to craft a comprehensive analysis of multiple differently weighted factors that contribute to a specialty’s competitiveness. I urge you to take a close look at the spreadsheet and play with the data to see for yourself.

Don’t let the data fool you though. Just because these are the ten least competitive specialties doesn’t mean they aren’t hard to get into. Every specialty in medicine is competitive; it’s just that some are more competitive than others. If you want to get the best training at a top program, you’ll have to be a stellar candidate.

Want to learn more? Here’s Why Some Specialties are More Competitive than others.

How to Choose a Specialty

Are you having trouble deciding what specialty to pursue? We have a series dedicated to dissecting different specialties and subspecialties called “So You Want to Be…” The series takes a comprehensive look at 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 a Reproductive Endocrinologist
• So You Want to Be a Pathologist
• So You Want to Be an Interventional Cardiologist
• So You Want To Be a General Surgeon
• So You Want to Be an Endocrinologist

We continually add to this series, so be sure to follow along on the Med School Insiders blog. If you don’t see a specialty you’re interested in, leave a comment below or contact our team to request an analysis.

Competitively Pursue Any Specialty

Our team at Med School Insiders has served on admissions committees at top medical schools and residency programs, and we specialize in getting you where you want to be. We don’t rely on wishful thinking or false promises. We’ve painstakingly developed our proprietary systems, which are designed with one purpose in mind—helping you become the successful doctor you’ve always dreamed of.

We’ve recruited the best in the industry and provided them with the most powerful tools in getting you where you want to be. Our results speak for themselves, and it’s why we’ve become the fastest-growing company in the space with the highest satisfaction ratings.

No matter what specialty you’re aiming for, we can get you there. Med School Insiders offers a range of multimedia courses designed to help you reach your potential. Check out our Comprehensive Residency Match Packages, which include essay editing, application editing, interview preparation, research advice, and more.