Most Competitive Residencies and Why?

[inmyimmddo]

I couldn't find any post recent enough that was of the same content, so I felt it was acceptable to start a new thread on the issue. If I overlooked one that is recent, then I sincerely apologize and please direct me there.

First off I want to preface the question and my interest by saying I am a long shot for getting into a med school, and therefore I expect I would be a long shot for any competitive residency. Obviously if I can't get into medical school, this topic is worthless in relation to me, but I am going to assume that I do get in/I want to take it into consideration with applying to medical school and considering my future.

Which residencies are the most competitive? Why are they so competitive? Why are certain popular specialties desirable? Assuming that I end up at the bottom portion of students at a medical school, answering honestly, this will most likely make it impossible for me (aside from some miracle or ridiculous connection happening) to get into something competitive, right? For example, I have a genuine interest (honestly leaving out the compensation) in plastic surgery. Being at the bottom will make that an impossibility, right? Or at least requiring of a miracle/unique and unlikely situation...

Please answer whatever of that you can; I would greatly appreciate it.

Whenever I am at the hospital I am so jealous of the doctors and it makes me feel even worse that I might not get the chance to be one But that's life and I am still interested in the answers to this, nonetheless. Thanks!

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[bad virus]

I just wanted to post before all of the d-bag responses of get into med school first pop in.

It all depends on the specialty. For example, the reasons that make EM residencies competitive are usually variety, acuity, and exposure; while the ones that would make an IM program competitive = home institution secondary to research funding, and ability to get fellowships from the institution.

Things that in general make a program more competitive are location. To summarize, it all depends on the specialty, with some of the factors being similar. I don't know much about plastics, so sorry I couldn't help you there.

I just wanted to be able to get in early and preemptively d-bag label all of the posters that will most likely come in soon., because they all have adhd or something that will not allow them to just focus on the question at hand instead of all the associated factors.

 

[da8s0859q]

I couldn't find any post recent enough that was of the same content, so I felt it was acceptable to start a new thread on the issue. If I overlooked one that is recent, then I sincerely apologize and please direct me there.

First off I want to preface the question and my interest by saying I am a long shot for getting into a med school, and therefore I expect I would be a long shot for any competitive residency. Obviously if I can't get into medical school, this topic is worthless in relation to me, but I am going to assume that I do get in/I want to take it into consideration with applying to medical school and considering my future.

Which residencies are the most competitive? Why are they so competitive? Why are certain popular specialties desirable? Assuming that I end up at the bottom portion of students at a medical school, answering honestly, this will most likely make it impossible for me (aside from some miracle or ridiculous connection happening) to get into something competitive, right? For example, I have a genuine interest (honestly leaving out the compensation) in plastic surgery. Being at the bottom will make that an impossibility, right? Or at least requiring of a miracle/unique and unlikely situation...

Please answer whatever of that you can; I would greatly appreciate it.

Whenever I am at the hospital I am so jealous of the doctors and it makes me feel even worse that I might not get the chance to be one But that's life and I am still interested in the answers to this, nonetheless. Thanks!

Specialty match statistics now might change by the time they apply to you. But in any case, the information you're looking for can be found here. Not much point in going over this as a premed though, to be honest.

In general, "competitive" specialties are such because (a) they pay well, and (b) the hours are nicer or at least fewer than a lot of other jobs in medicine. This is why anesthesiology, emergency medicine, and radiology are harder to get into than family medicine, pediatrics, and psychiatry. And is also why dermatology is notoriously competitive.

Location increases or decreases competitiveness of all specialties. More people want California programs than ones in the middle of nowhere.

And yes, plastic surgery is very, very competitive. But don't even think about these things at this point.

 

[FunnyCurrent]

I just wanted to post before all of the d-bag responses of get into med school first pop in.

It all depends on the specialty. For example, the reasons that make EM residencies competitive are usually variety, acuity, and exposure; while the ones that would make an IM program competitive = home institution secondary to research funding, and ability to get fellowships from the institution.

Things that in general make a program more competitive are location. To summarize, it all depends on the specialty, with some of the factors being similar. I don't know much about plastics, so sorry I couldn't help you there.

I just wanted to be able to get in early and preemptively d-bag label all of the posters that will most likely come in soon., because they all have adhd or something that will not allow them to just focus on the question at hand instead of all the associated factors.

Way to ruin our fun you ass

 

[chronicidal]

For example, I have a genuine interest (honestly leaving out the compensation) in plastic surgery. Being at the bottom will make that an impossibility, right? Or at least requiring of a miracle/unique and unlikely situation...

Yes.

 

[bad virus]

Way to ruin our fun you ass

Didn't you just get into school?

Sorry, just messing with you man, love the name "If"

 

[inmyimmddo]

Yeah I know it is early. But I still am interested in it (even if I don't end up going to med school) and more importantly, what the viable possibilities are for my future have an impact on my decision. As would be obvious, I would prefer to only spend all the time required for medicine if I could be sure I would get the chance to end up in a specialty that I liked. I'm open to a number of things, but at the same time, it is just plain facts that I and any other person would be relatively disappointed in certain areas. The main point being, thanks for being honest that it is not important to reference at this point, but I would like to read about it out of pure interest.

To specifically bring a couple specialties up that I have heard are popular/competitive, why are urology and/or radiology so popular?

So you were saying dermatology is pay/hours?

 

[Taus]

more competitive = a combo of $$, lifestyle and prestige

 

[inmyimmddo]

Specialty match statistics now might change by the time they apply to you. But in any case, the information you're looking for can be found here. Not much point in going over this as a premed though, to be honest.

I know medicine is going through a ton of change currently and it will continue to change in upredicted ways within the near future, but barring some massive restructuring in medicine, are specialty match statistics really likely to change that much for me? I obviously don't have knowledge to back it up with, but why would plastic surgery (or residences with similar levels of competitiveness) every become any less competitive, once again barring a massive restructuring in medicine...?


By the way, thanks a bunch for any info/to the posters who have already replied. I greatly appreciate it. And d-bags are a sad but ever present existence w/ the internet... so meh to that.

 

[bad virus]

To specifically bring a couple specialties up that I have heard are popular/competitive, why are urology and/or radiology so popular?

So you were saying dermatology is pay/hours?

To be honest with you. You really never know what your going to like. I knew I wanted Peds before hand, and I still love peds, but I am going into EM next year. Also, I never in a blue moon thought I would enjoy OB, but maternal fetal medicine has to be the best god damn specialty on the planet. Also, I really thought I would love to be a trauma surgeon, but i realized that I get cabin fever 2 hours into an operation and being sterile.

So basically, you might have an idea, but you never really know, so don't base whether you will apply on your future prospect of matching into plastics. Also, who in the hell says you can't be a rock star in med school just cuz you weren't a rock star in undergrad. I hated high school and dragged my ass over the ground while in undergrad, yet destroyed the last three years while here. Lucky for me most of our evaluation in med school is in the form of multiple guess exams, which is my specialty in life. Also, third year is easy if you are fun and funny to be around. I have honored every rotation based on charm/smile alone. I am not any smarter than any of my fellow class mates but just know how much a smile is worth on a cloudy day.

To summarize all of my self aggrendization, You can be a top medical student if you are charming and do well on Multiple choice exams.

Now in regards to urology, well for me it would be the prospect of mixing business with pleasure. K, I am not sure what the appeal is to be honest. For rads, it's the hours/pay just like in derm. This will change soon though so becareful if you want to do something for money.

In regards to cash: As a pediatrician, you will make no less than 80K. That is the worst case scenario. Hell my pops never ever in hilife came close to that, so anything above that is golden cherries for me.

I don't have the facts to back this up (Herman Cain), but I would venture to guess that 80k is top quartile of income in the US.

 

[inmyimmddo]

In regards to cash: As a pediatrician, you will make no less than 80K. That is the worst case scenario. Hell my pops never ever in hilife came close to that, so anything above that is golden cherries for me.

I don't have the facts to back this up (Herman Cain), but I would venture to guess that 80k is top quartile of income in the US.

Just for reference, super reliable wikipedia says no more than 7 percent of America makes more than 100 k. And only around 12 percent makes over 75 k. I think I read that correctly.

And money is of course a consideration, but this really has more to do with interest. From what I know now, peds (em over others)/psych would be my #2 and #3. The way I see it, as a physician has told me previously, is that no matter where you are in medicine, you will be making good money relative to society in general. Which was basically the point you were getting at too, I'm assuming.

 

[valkener]

Since when do people consider EM to be as competitive as radiology or anesthesiology? Just wondering since this is my biggest interest so far.

 

[neusu]

In general, "competitive" specialties are such because (a) they pay well, and (b) the hours are nicer or at least fewer than a lot of other jobs in medicine. This is why anesthesiology, emergency medicine, and radiology are harder to get into than family medicine, pediatrics, and psychiatry. And is also why dermatology is notoriously competitive.

I'd argue of all the fields you listed, only dermatology is competative. Orthopedics, otolaryngology, neurosurgery, urology, plastics, vascular, and integrated cardiothoracic are all more competetive than the rest of the fields you listed. None of them are "lifestyle" fields (though some more so than the others).

 

[pntgrd]

Competitiveness is proportional to (income/effort). All the competitive specialties are therefore relatively lucrative and/or decent lifestyle. Very few people think derm is fascinating, despite the likely indignation from those going into it.

 

[SteinUmStein]

Competitiveness is proportional to (income/effort). All the competitive specialties are therefore relatively lucrative and/or decent lifestyle. Very few people think derm is fascinating, despite the likely indignation from those going into it.

We had a derm lunch talk where they bent over backwards trying to convince us (and themselves) how interesting derm really is. Tack on 15 more hours a week for the same pay or dock their pay 30% to be more in line with other specialties for pay/hr and we'll see how interesting the skin is...

 

[da8s0859q]

Since when do people consider EM to be as competitive as radiology or anesthesiology? Just wondering since this is my biggest interest so far.

I'd argue of all the fields you listed, only dermatology is competative. Orthopedics, otolaryngology, neurosurgery, urology, plastics, vascular, and integrated cardiothoracic are all more competetive than the rest of the fields you listed. None of them are "lifestyle" fields (though some more so than the others).

I was just saying that EM, gas, and rads are all more competitive than FM, peds, and psych for reasons of lifestyle and pay. Didn't mean to suggest that they're competitive in the same sense that surgical subspecialties are. That's derm / rad onc territory.

I know medicine is going through a ton of change currently and it will continue to change in upredicted ways within the near future, but barring some massive restructuring in medicine, are specialty match statistics really likely to change that much for me?

Who knows. In the past few years that I've been a med student, gas and EM have been creeping up in competitiveness with every match. Radiology is supposedly easier to match into now than it was previously. Doubt that there'd be drastic changes, but you're looking at several years before you apply. No telling what the numbers will look like then.

 

[GoSpursGo]

I'm going to go ahead and move this over to pre-allo. Allo is a forum for med students to discuss issues that are relevant to their current stage in training; med students frequently check the pre-allo forum and answer these kinds of questions there.

 

[xroc]

Since when do people consider EM to be as competitive as radiology or anesthesiology? Just wondering since this is my biggest interest so far.

Anesthesiology and Radiology were both considered "low competitiveness" specialties in 2011, with match rates of 97%/98% respectively. Emergency Medicine was considered an "intermediate competitiveness" specialty, with a match rate of 93% in 2011.

source: http://residency.wustl.edu/medadmin...62353a93c5c35cb186256f850071bd86?OpenDocument

 

[flatearth22]

To what extent are certain specialties competitive because they're competitive. That is, part of their competitiveness comes from the fact that people want to validate their efforts/impress their peers by going into a competitive specialty? Do some people look at matching into Derm, Plastics, Ortho, etc. a challenge and an opportunity to show they have the intelligence and work ethic to make it there in the first place?

And is the opposite true? Do people want to avoid Family Practice, Psych, Peds, etc. partly because they're so easy to match into and have lots of foreign grads and DO's in them?

 

[littlealex]

Derm, plastics, rad-onc, orthopedics are going to be challenging matches for you if you're at the bottom half. However, they're by no means impossible. Work hard, do research early. Give it your best shot and see how it turns out.

 

[drizzt3117]

Anesthesiology and Radiology were both considered "low competitiveness" specialties in 2011, with match rates of 97%/98% respectively. Emergency Medicine was considered an "intermediate competitiveness" specialty, with a match rate of 93% in 2011.

source: http://residency.wustl.edu/medadmin...62353a93c5c35cb186256f850071bd86?OpenDocument

I think that like GS and IM you see a lot of stratification in rads between programs. It's very easy to match into low tier programs, especially those in undesirable areas, but the top programs are very hard to get into with extremely high step 1 scores. Rads has the most applicants with step 1 > 260 of any specialty except IM (which has 4-5x the applicants)

 

[inmyimmddo]

How badly does being a DO hurt you for getting into MD residencies in general?

Also, yeah, I am kind of surprised that EM is competitive. I can't say my sources were the best, but I heard a few people discussing how the lifestyle (in terms of hours and being on call frequently) of EM is pretty terrible. If lifestyle is a major consideration, as some have been mentioning, than I would expect it to not be so competitive.

How is anesthesia not more competitive, I have always been under the impression it was a well paying specialty? For a number of years I had heard it was a hot specialty in medicine.

 

[drizzt3117]

How badly does being a DO hurt you for getting into MD residencies in general?

Also, yeah, I am kind of surprised that EM is competitive. I can't say my sources were the best, but I heard a few people discussing how the lifestyle (in terms of hours and being on call frequently) of EM is pretty terrible. If lifestyle is a major consideration, as some have been mentioning, than I would expect it to not be so competitive.

How is anesthesia not more competitive, I have always been under the impression it was a well paying specialty? For a number of years I had heard it was a hot specialty in medicine.

There's no call in EM. The hours are very good compared to other residencies like surgery.

 

[UrshumMurshum]

We had a derm lunch talk where they bent over backwards trying to convince us (and themselves) how interesting derm really is. Tack on 15 more hours a week for the same pay or dock their pay 30% to be more in line with other specialties for pay/hr and we'll see how interesting the skin is...

 

[theseeker4]

How badly does being a DO hurt you for getting into MD residencies in general?

Also, yeah, I am kind of surprised that EM is competitive. I can't say my sources were the best, but I heard a few people discussing how the lifestyle (in terms of hours and being on call frequently) of EM is pretty terrible. If lifestyle is a major consideration, as some have been mentioning, than I would expect it to not be so competitive.

How is anesthesia not more competitive, I have always been under the impression it was a well paying specialty? For a number of years I had heard it was a hot specialty in medicine.

Attraction of EM is there is no call, you work few hours per month compared to other specialties (40 hours a week is considered a very busy schedule over in the EM forum), and pay is good. It isn't a "lifestyle specialty," per se, because you have to work lots of nights/weekend/holidays which is inconvenient to many people's lifestyles. The fact that there is a good variety of patients, high acuity, no continuous census of patients, etc. also makes it attractive to many doctors.

 

[slowbutsteady]

Match rate is a poor measure of competitiveness. There are zillions of reasons why a specialty might not fully match that have nothing to do with its competitiveness.

Look at the average Step I scores for each specialty. That is more helpful.

 

[SunsFun]

I was always curious about the lure of ENT. It seems to be very competitive looking at STEP 1, yet not too many people talk about it.

 

[coldleg]

From the NRMP website, for the 2012 match:

Dermatology, orthopaedic surgery, otolaryngology, plastic surgery, radiation oncology, thoracic surgery, and vascular surgery were the most competitive fields for applicants.

http://www.nrmp.org/pressrelease2012.pdf

 

[flatearth22]

From the NRMP website, for the 2012 match:



http://www.nrmp.org/pressrelease2012.pdf

I'm surprised they didn't list Neurosurgery as well.

 

[SunsFun]

This gives a good picture too:

http://www.nrmp.org/data/chartingoutcomes2011.pdf


Based in the STEP 1 scores distribution I would argue that plastics is the most competitive specialty. The likelihood of matching doesn't go far beyond 70% even when the score is above 260.

 

[druggeek]

Derm, Plastics, Ortho, Neurosurgery... etc etc

why?

Because they contain 2 of the 3:

1) money
2) lifestyle
3) prestige

In addition, all provide a sense of achievement (though the only possible way anyone gets satisfied with derm is by the fact that they beat out so many people for it lol..).

Here in Canada, Optho is the most competitive specialty, just over derm and plastics.

 

[inmyimmddo]

I understand plastics pays beyond well, but at the same time, it doesn't match some other specialties. So I am still a bit puzzled by its allure over others. I get the feeling that all surgery specialties have a low lifestyle amount since there is so much stress and work required for surgeries.

And radiology is still a major surprise to me. What is so appealing about it? I understand the overall idea that the "best" specialties have some mix of money/lifestyle/prestige, but what is it for radiology?

 

[Plue00]

I understand plastics pays beyond well, but at the same time, it doesn't match some other specialties. So I am still a bit puzzled by its allure over others. I get the feeling that all surgery specialties have a low lifestyle amount since there is so much stress and work required for surgeries.

And radiology is still a major surprise to me. What is so appealing about it? I understand the overall idea that the "best" specialties have some mix of money/lifestyle/prestige, but what is it for radiology?

Radiologists can bank, that's what. It's funny, my uncle graduated from med school in the 70s from the UK and was applying for a residency spot here. No one wanted radiology at that time and he said his advisers told him radiology would probably be the safest bet for any foreign student. Now I think he makes over 500k doing IR 4 days a week. Not bad at all. He said radiology is always expanding and that's why it's competitive now. (I really have no idea if it's true or not, I know nothing about that kind of stuff haha).

 

[deragoku]

The competition features, relatively rich and / or a decent way of life. Very few people think that leather is a charming, although it may be from its indignation.

 

[mmmcdowe]

I'm surprised they didn't list Neurosurgery as well.

Yeah... Until a few years ago neurosurg was often excluded from the match report all together, so baby steps.

 

[DubVille]

32.4%

 

[HughMyron]

For example, I have a genuine interest (honestly leaving out the compensation) in plastic surgery. Being at the bottom will make that an impossibility, right? Or at least requiring of a miracle/unique and unlikely situation...

Yeah it's an impossibility to match plastics if you're a low-tier student. Look into Family Practice, OB/GYN, or Psychiatry.

Look on the bright side, most plastic surgeons spend their time working on burn victims rather than boob jobs.

 

[pinipig523]

Anesthesiology and Radiology were both considered "low competitiveness" specialties in 2011, with match rates of 97%/98% respectively. Emergency Medicine was considered an "intermediate competitiveness" specialty, with a match rate of 93% in 2011.

source: http://residency.wustl.edu/medadmin...62353a93c5c35cb186256f850071bd86?OpenDocument

I really doubt rads is less competitive than EM... the match rates are not predictive of competetiveness given that a good majority of people will self-select out of a particular specialty before even applying.

 

[235009]

let's get a few things straight.....

1. EM and anesthesia are not competitive. they are considered to be lifestyle specialties because of lack of call (EM) or regularity of schedule (anesthesia) but it is not difficult to match into either.
2. a big factor that determines competitiveness, especially of the surgical subspecialties, is supply and demand. for some specialties there are just so few spots out there that the residencies can be particularly choosy.
3. premeds have a very warped sense of how med students pick their careers. that's why so many premeds enter med school thinking they want to be neurosurgeons or plastic surgeons and later find that those career paths are miserable and will never afford them the flexibility to enjoy life.

 

[HughMyron]

let's get a few things straight.....

1. EM and anesthesia are not competitive. they are considered to be lifestyle specialties because of lack of call (EM) or regularity of schedule (anesthesia) but it is not difficult to match into either.
2. a big factor that determines competitiveness, especially of the surgical subspecialties, is supply and demand. for some specialties there are just so few spots out there that the residencies can be particularly choosy.
3. premeds have a very warped sense of how med students pick their careers. that's why so many premeds enter med school thinking they want to be neurosurgeons or plastic surgeons and later find that those career paths are miserable and will never afford them the flexibility to enjoy life.

Lot of misconceptions in particular about plastic surgery...people think all they do is Botox, Lipo, and Boobjobs. In reality, most plastic surgeons work with burn victims and other reconstructive issues.

So anyways, how DO medical students choose specialties, versus how premeds think they choose them?

 

[NickNaylor]

Lot of misconceptions in particular about plastic surgery...people think all they do is Botox, Lipo, and Boobjobs. In reality, most plastic surgeons work with burn victims and other reconstructive issues.

So anyways, how DO medical students choose specialties, versus how premeds think they choose them?

Personal interest, role on the care team, the patient population, lifestyle considerations - to name a few.

(sent from my phone)

 

[PTPoeny]

Here are some interesting notes from the 2012 match:

 Specialties and specialty tracks with at least 10 positions in The Match and 100 percent fill rates:
Dermatology (PGY-1)
Emergency Medicine
Orthopedic Surgery
Physical Medicine and Rehabilitation (PGY-1)
Plastic Surgery (PGY-2)
Radiation Oncology (PGY-1)
Thoracic Surgery
Vascular Surgery

 Specialties with at least 10 positions in The Match and filled more than 90 percent by U.S. seniors:
Radiation Oncology (PGY-1): 100 percent
Radiation Oncology (PGY-2): 98.1 percent
Otolaryngology: 97.2 percent
Dermatology (PGY-1): 95.7 percent
Plastic Surgery (PGY-2): 95.0 percent
Thoracic Surgery: 95.0 percent
Orthopedic Surgery: 94.0 percent
Vascular Surgery: 92.7 percent

In general you can go to the NRMP website and look at the different reports and you can find things like % of US seniors matching in a given specialty and average step 1 score and fun stuff like that: http://www.nrmp.org/data/index.html They also have old reports and some looking at trends over time.

And things do change. Anesthesia is way less competitive than when I started. EM and PM&R are way more competitive. And there is a lot more variability between programs in less competitive fields. In plastic surgery or ENT all the programs are going to screen by step 1 score, but only the top peds programs do the same. But the top peds programs might use the same step 1 screening score as the more competitive fields.

 

[235009]

So anyways, how DO medical students choose specialties, versus how premeds think they choose them?

alot of it comes down to what you find interesting and rewarding. also your experiences during your clerkships ...whether you interacted with an attending who was particularly inspiring or got along with the residents particularly well. the opposite is also true... many people eliminate specialties based on negative experiences during third year. finally depending on your motivation and what else is going on in your life outside of med school (wife/husband, kids, etc) you might opt for a more lifestyle friendly specialty within your area of interest. that's why ENT and Urology are very popular ...most of the people pursuing those paths are interested in surgery but don't want the general surgery lifestyle.

it is quite rare that a US MD student will be "forced" into a non-competitive specialty. it's true that some have to settle for a less competitive version of the same field (gen surg instead of uro or ENT) but the premed delusion that you'll have to be "forced" into IM, FM, peds or psych is simply not true for US MDs, except for a rare few who REALLY screwed up in med school. The same cannot be said for US IMGs, FMGs and DOs who run into roadblocks that can be insurmountable in some smaller or more competitive specialties.

i hope this begins to erode the SDN myth that med students will go for the most competitive specialty they can get into and that noone willingly goes into less competitive specialties.

 

[pre med 2014]

Dermatology