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

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 average 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 recent data from the National Residency Matching Program (NRMP) to 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.

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:

  1. Plastic Surgery
  2. ENT
  3. Dermatology
  4. Orthopedic Surgery
  5. Neurosurgery
  6. Thoracic Surgery
  7. Urology
  8. Vascular Surgery
  9. Interventional Radiology
  10. Diagnostic Radiology

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

Updated 2022: Top 10 Most Competitive Specialties in Medicine | Med School Insiders (1)

What the Data Says

In total, we examined 24 different specialties using data gathered from the National Residency Matching Program (NRMP). We examined 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.

The top 40 NIH-funded medical schools are usually more competitive, meaning students who got into these schools were, on average, stronger students. AOA, or the Alpha Omega Alpha Honor Medical Society, is often a good indicator of being a high-performing student, but it’s not perfect, as not all schools have it.

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.

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.

The specialty with the highest total points is plastic surgery, followed by ENT, and dermatology.

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 an inaccurate marker of competitiveness. Keep in mind that due to a lack of complete data, ophthalmology was not included in this analysis.

If you want to evaluate the data yourself, we have an entire spreadsheet with all of our calculations.

1 | Plastic Surgery

Plastic surgery ranks number one with a total of 94 points. This specialty ranks high across nearly all six of our data categories, with the exception of Top 40 NIH.

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 | ENT

In the second spot is the ENT specialty (Otorhinolaryngology), with a high AOA percentage and Step scores.

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.

3 | Dermatology

The dermatology specialty dropped down to the third spot based on recent data, but this specialty is strong in all six of our data categories.

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.

4 | Orthopedic Surgery

Orthopedic surgery ranks in the number four spot, with fairly high rankings in all six categories, except for Top 40 NIH, in which orthopedic surgery ranks mid-range of 24 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.

5 | Neurosurgery

The neurosurgery specialty is next, ranking fairly high across all six categories, with a slightly lower ranking for match rate and Step 2 CK score.

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.

Final Thoughts

There’s always complaints about imperfect methodologies. Every analysis has its limitations. I urge you to take a close look at the spreadsheet and play with the data to see for yourself.

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: 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.

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.


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  3. Cardiology. ...
  4. Psychiatry. ...
  5. Gastroenterology. ...
  6. Internal Medicine. ...
  7. Neurology. ...
  8. Pulmonary Medicine/Critical Care.
Feb 8, 2022

What is the hardest residency to match? ›

What are the Most Competitive Residencies?
  • Neurosurgery.
  • Orthopedic Surgery.
  • ENT/Otolaryngology.
  • Interventional Radiology.
  • Vascular surgery.
  • Thoracic surgery.
  • Radiation Oncology.
  • Internal Medicine – Pediatrics.
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What is the hardest specialty in the medical field? ›

Apart from the top 5 specialties mentioned above, Interventional Radiology, Radiation Oncology, Vascular Surgery, General Surgery and Med/Peds are among the most difficult domains to become a doctor.

What is the most respected medical specialty? ›

The Top Most Competitive Specialties in Medicine
  • Dermatology.
  • Orthopedic Surgery.
  • Neurosurgery.
  • Thoracic Surgery.
  • Urology.
  • Vascular Surgery.
  • Interventional Radiology.
  • Diagnostic Radiology.
Sep 11, 2022

What is the happiest medical specialties? ›

Happiest Specialties

According to Medscape's 2020 Physician Lifestyle and Happiness Report, the specialties with the greatest proportion of happy physicians were rheumatology at number one followed by general surgery, public health & preventive medicine, allergy & immunology, and orthopedics.

What is the fastest growing medical specialty? ›

Sports medicine was once primarily the domain of the pro athlete, but increased interest in fitness and the availability of health insurance helped put the specialty at the top of the list of the fastest growing medical specialties. The AAMC found that the field grew at a rate of 42.5% between 2016 and 2021.

What type of doctor has the best work life balance? ›

Family medicine doctors tend to have great work/life balance. Most work typical 9-5's in a private setting and leave all their work behind at the end of the day.

Which specialty has the most residency spots? ›

  • Internal medicine –12,475 first-year residency positions (including preliminary positions)
  • Family medicine – 5,487 first-year residency positions.
  • Pediatrics – 3,317 first-year residency positions.
  • Surgery-general – 3,145 first-year residency positions (including preliminary positions)
6 days ago

Which doctor has the easiest residency? ›

The 10 Least Competitive Specialties in Medicine
  • Family Medicine.
  • Pediatrics.
  • Psychiatry.
  • Emergency Medicine.
  • Physical Medicine & Rehabilitation.
  • Neurology.
  • Child Neurology.
  • Pathology.
Sep 10, 2022

Which medical residency is the least stressful? ›

Least stressful specialties by burnout rate
  • Ophthalmology: 33%. ...
  • Orthopedics: 34%. ...
  • Emergency medicine: 45%. ...
  • Internal medicine: 46%. ...
  • Obstetrics and gynecology: 46%. ...
  • Family medicine: 47%. ...
  • Neurology: 48%. ...
  • Critical care: 48%. An ICU doctor sees people die almost daily, which can be extremely difficult to handle.
Nov 14, 2022

What medical specialty has the highest burnout rate? ›

29 physician specialties ranked by 2022 burnout rates
  • Emergency medicine — 65 percent of physicians reported burnout.
  • Internal medicine — 60 percent.
  • Pediatrics — 59 percent.
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  • Family medicine — 57 percent.
  • Neurology — 55 percent. ...
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  • Oncology — 52 percent.
Feb 1, 2023

What is the most relaxed medical specialty? ›

Here is our list of the top 10 happiest doctor specialties according to work-life balance:
  • Family Medicine.
  • Otolaryngology.
  • Dermatology.
  • Anesthesiology.
  • Ophthalmology.
  • Pediatrics.
  • Psychiatry.
  • Clinical Immunology/Allergy.
Jun 9, 2022

What is the highest paid specialty? ›

1. What are the highest paid doctors in the United States? According to the latest statistics, physicians working in the orthopedics specialty are the highest earning doctors in the US, with an average annual income of US$511K. 2.

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That being said, there are some specialties with less face-to-face patient interaction where you can spend more of your time alone.
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Oct 22, 2022

What is the smartest doctor specialty? ›

Internal Medicine:

When society generally thinks of doctors, they are thinking of internists. They are often the smartest and most well- rounded physicians due to the breadth of knowledge they (along with family medicine physicians) often carry.

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Physician specialties with the happiest marriages
  • Nephrology: 85 percent.
  • ENT: 85 percent.
  • Pediatrics: 84 percent.
  • Orthopedics: 84 percent.
  • Gastroenterology: 84 percent.
  • Ophthalmology: 84 percent.
  • Plastic surgery: 84 percent.
  • Family medicine: 83 percent.
Jan 23, 2023

Which medical specialty has a shortage of physicians? ›

Cardiology has the highest projected shortage of physicians, according to Physicians Thrive's "2022 Physician Compensation Report."

What is the newest medical specialty? ›

Here are five new specialties, what they entail, and the training needed to pursue them.
  1. Cancer immunologist. ...
  2. Nocturnist. ...
  3. Lifestyle medicine physician. ...
  4. Clinical informatics. ...
  5. Medical virtualist.

What doctor works the least hours? ›

With that said, here are the 10 doctor specialties with the lowest hourly rate.
  • Infectious Disease.
  • Pediatrics. ...
  • Endocrinology. ...
  • Rheumatology. ...
  • Preventive Medicine. ...
  • Allergy & Immunology. ...
  • Neurology. ...
  • Psychiatry. Number 10 is psychiatry, which focuses on the diagnosis, prevention, and treatment of mental disorders. ...
Feb 23, 2022

What type of doctor works the most hours? ›

Compared with primary care, researchers found that surgery, internal medicine, and pediatric subspecialties tended to have the longest working hours. Specifically, those working in vascular surgery, critical care internal medicine, and neonatal and perinatal medicine had the longest workweeks.

Which doctor has the least residency? ›

Family medicine is the specialty that provides the shortest residency program in the U.S. as it only takes 3 years and possibly another year more if the resident opts to continue with the subspecialty fellowship.

What is the highest paid Dr? ›

What is the best paying job in medical specialties and fields? Anesthesiologists are among some of the highest earners in the medical field. According to the BLS, these professionals earned an average income of $331,190 in May 2021. However, earning potential may vary by state.

What are the least competitive internal medicine fellowships? ›

Internal Medicine.

The least competitive subspecialty was pulmonary disease (16%). However, relatively few physicians do a pulmonary-only fellowship (25 positions) and the vast majority do a combined pulmonary & critical care medicine fellowship (721 positions).

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Top 5 Easiest Medical Schools : Based on Acceptance Rate
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  • University of North Dakota School of Medicine and Health Sciences.

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Least Competitive Medical Specialties
  1. Family Medicine. Average Step 1 Score: 215.5. ...
  2. Psychiatry. Average Step 1 Score: 222.8. ...
  3. Physical Medicine and Rehabilitation. Average Step 1 Score: 224.2. ...
  4. Pediatrics. Average Step 1 Score: 225.4. ...
  5. Pathology. Average Step 1 Score: 225.6. ...
  6. Internal Medicine (Categorical)
May 20, 2021

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Year one is the hardest year of medical school.

Many students will likely disagree, but the first year is widely recognized as being the most difficult. The majority of the first year of medical school is spent in classrooms and labs and requires an enormous amount of memorization.

Which doctor has more demand in future? ›

Blog Summary. The top specialties that are in demand and offer exceptional career growth are orthopedics, internal medicine, ob-gyn, dermatology, pediatrics, radiology, general surgery, ophthalmology, family medicine, chest medicine, aesthesia, pathology and ENT.

What is the fastest growing medical specialties? ›

Just behind sports medicine, with a 37% increase in active physicians from 2016 to 2021, was pediatric anesthesiology. The AAMC found there were 2,843 pediatric anesthesiologists in 2021, 51% of them female.

Which Speciality is the future of medicine? ›

Psychiatry, emergency medicine or nursing will be supported

All specialities where human factors such as empathy and caring attention are the core of the practice, high levels of creativity and problem solving, and quick decision-making abilities will override any technological solution in the majority of cases.

What medical specialty has a shortage? ›

Cardiology has the highest projected shortage of physicians, according to Physicians Thrive's "2022 Physician Compensation Report."

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Plastic surgery and orthopedics most frequently topped the list as the highest-paying physician specialty in the last five years, according to Medscape compensation reports.


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