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Yes, it's the most competitive. I hypothesized about this last year. Let me add another observation: I've met numerous surgical and medicine attendings who've said, "I think IR would've been the perfect fit for me, had I known it existed." Conversely, I haven't met a single IR who has said, "I wish I'd done something else." IR docs seem quite happy about their specialty choice, even with demanding hours. Whether this is because of the work itself, or the "fallback" of doing diagnostic reads (I don't think this is likely), IR seems to be quite a rewarding speciality.