Most/Least competitive Residencies

[LDSdoc]

Does anyone have a link to the most/least competitive residencies that is current? Thanks.

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[Winged Scapula]

Old question to which there is no one "real" answer. This is because "competitive" comprises many variables and no one program will be across the board "most" for any one specialty.

For example, while Pathology is not generally considered competitive, you can bet that a Path residency at say, UC San Francisco, is more competitive than a General Surgery residency at some podunk community hospital (or even some university based programs).

In general, the MOST competitive programs are (in no particular order):

Rads
Neurosurg
ENT
Urology
Ortho
Integrated Plastic Surgery
Derm
Rad Onc
...to name a few...

The LEAST competitive (again, in no certain order and to name a few):

Path
IM
Psychiatry
FP
Peds

This will obviously vary from program to program as noted above, and as well with geographic location. At any rate, I'll move this to the General Residency Issues forum where it belongs...

 

[hndrx1a]

KIMBERLY, CAN IT BE THAT A SURGEON LEFT-OUT ANESTHESIA?!

 

[path1]

Kimberly,

While path is considered noncompetitive, as someone who is going into path i will say it is getting more and more competitive everyday vs. surgery. This may have to do with lifestyle changes, $$ is better and you have a life outside of medicine and a family. These things are cyclic but i've noticed med students nowadays are more concerned with family, life outside of medicine and reimbursments.

 

[Mindy]

I have to second Path1's assessment. I think this upcoming year is going to be more challenging for future pathologists (except of course for those on this forum for reasons described in the pathology forum ).

I think that part of this is simply because we are a small field. If 3 students per medical school decide to go into pathology, the residency positions are filled up. It would be unwise to choose pathology based on a sensation of "an easy match." Not a good reason anyway to choose a field that involves innumerable openings of stinky, full, incubator bowels.

Go Path Mafia Go!

Mindy

 

[Winged Scapula]

Now before this thread becomes inundated with comments like, "WHAT?!!? You left out specialty X which ALWAYS FILLS with Harvard students, etc."

Please note the following:

a) the OP asked about which were the most/least competitive - because I consider Anesthesia in neither category( although like Path, moving up in popularity) I left it out because I believe it falls somewhere in the middle (you'll note I left out Gen Surg);

b) my list was not meant to be complete; I believe such a list DOES NOT exist and the OP might be better off referring to the extensive discussions here and elsewhere about the subject or by simply following his/her heart without regard to competitiveness;

and c) I KNOW Path is becoming more competitive; I have a close friend who went through the match for Path last year. However, the OP did not ask what programs/specialties were becoming more/less competitive. Therefore, while Path has seen an upswing in popularity over the last couple of years, it likely still does not move it from the realm of least competitive. I may change that statement over the next few years. Especially if Great Pumpkin eeps posting his great call schedule.

So for all the defenders of their various fields out there, rather than taking offense how about answering the OP's query?

 

[hotbovie1]

I'll add ophthalmology to the competitive list.

Neurology to the not very competitive list (per one of our very popular neurology staff...all you need to get in is a pulse)

 

[ckplay]

rad is over-rated. a couple of guys in my class matched rad with so-so numbers.

 

[Mindy]

I'm telling ya, I doubt that pathology is going to be in the "least competitive" pile this match. I am actually not defending my specialty (Am I trying to prove to myself that if it is competitive it is a good field?), I am saying it is a small field with a huge boost in interest for many reasons. If someone is trying to find a "less competitive" specialty so that they can either 1) match at a brand-name institution, or 2) because they think they are themselves less competitive, they may be disappointed by the 2004 pathology match. I have colleagues (post-soph fellows, published, AOA) who were quite disappointed at their match this year. Not to mention the boost in interest: 1 pathologist in the class of 2002, 5 pathologists in my class of 2003. While 1 school certainly is not a quorum, anectdotal evidence points to others having a similar experience. The raw nrmp data shows that pathology had one of the largest jumps in interest compared to other specialties. Many of the program directors have said the candidates were outstanding this year (please refer to my list in the pathology forum, "MSIII poll" if interested in which programs) with a large influx of MD/PhD's attracted to the mating of science and clinical. SDN's Rirrirri has demonstrated 27 MSIIIs dedicated to pursuing pathology on this forum alone. Plus we have a radiology fall-out group that are using pathology as a back-up specialty due to the perceived ease of entry.

I hope I have not strayed too far off topic as proposed by Kimberli. While I certainly cannot speak about the competition in other fields, I do feel I have a decent handle on what's going on in pathology and can share those experiences with SDN. I do not agree that the expansion of this discussion into the specifics of a particular field takes us terribly off subject, but if it does feel free to point that out. Finally, to revisit the idea of defending one's field, one has to admit there is certainly a hint of condescension when a certain specialty is referred to as "non-competitive". Honestly, this does rub me the wrong way.

Mindy

 

[OneRadMan]

Originally posted by ckplay
rad is over-rated. a couple of guys in my class matched rad with so-so numbers.

ummmmm........right. That is why there were about 450 unmatched in rads this year. Compare to other specialties (# unmatched/#positions):

Radiology - 5/979
Ortho - 7/575
Derm - 2/272
Anesthesia - 53/1264
Rad Onc - 0/117

You do the math. Rads this year was more competitive than what we were all expecting. Your friends were lucky, many others were not....

 

[ckplay]

didn't say rad is not competitive, just over-rated. some rad-heads try to elevate it to the level of derm...not even close. just for comparison, at my school, a mid-tier US school, typically 1-3 derm and 10-15 rad matches per year. this year, derm 3 and rad 17.

personally i'm glad rad is getting more quality grads b/c there are some really useless rad attendings in practice.

 

[eddieberetta]

Originally posted by ckplay
didn't say rad is not competitive, just over-rated. some rad-heads try to elevate it to the level of derm...not even close. just for comparison, at my school, a mid-tier US school, typically 1-3 derm and 10-15 rad matches per year. this year, derm 3 and rad 17.

personally i'm glad rad is getting more quality grads b/c there are some really useless rad attendings in practice.

Umm, I know it's a hard concept, but the number of people who match to a program (in a given school or overall) doesn't necessarily reflect the competitiveness of the specialty.

See, competitiveness depends both on the number of positions, and the number of people applying. The numbers you have quoted reflect the relative number of positions offered in each specialty. And your anecdote about guys in your class doesn't really mean anything.

 

[OneRadMan]

Originally posted by ckplay
didn't say rad is not competitive, just over-rated. some rad-heads try to elevate it to the level of derm...not even close. just for comparison, at my school, a mid-tier US school, typically 1-3 derm and 10-15 rad matches per year. this year, derm 3 and rad 17.

personally i'm glad rad is getting more quality grads b/c there are some really useless rad attendings in practice.

Do you know how many people applied to Derm this year? There were about 1450 rad applicants for about 980 spots (not sure how many were Rad-or-bust vs those who applied to one rad program).........

 

[neo]

Originally posted by eddieberetta
Umm, I know it's a hard concept, but the number of people who match to a program (in a given school or overall) doesn't necessarily reflect the competitiveness of the specialty.

See, competitiveness depends both on the number of positions, and the number of people applying. The numbers you have quoted reflect the relative number of positions offered in each specialty. And your anecdote about guys in your class doesn't really mean anything.

very good point, and also, its not just number applying vs number of positions. people self select themselves when applying to residency. for example, not too many people who are in the bottom third of the class and have below average board scores are gonna apply to things like ENT, derm, rad onc because they realize that it's probably pointless. so you have to look at number of applicants vs number of positions AND things like average board score, class rank, number of AOA, etc. which is somewhat difficult to do because not all data of that type is released to the general public.

 

[ckplay]

See, competitiveness depends both on the number of positions, and the number of people applying.

competitiveness is more than just supply and demand. like neo said, it also depends on the quality of the applicant pool. unless nrmp release board scores, aoa, grades, etc., there's no way to objectively compare

Do you know how many people applied to Derm this year?

it's been roughly 3 applicants to 1 position. but, again, this is probably a more select group of applicants.

 

[eddieberetta]

Originally posted by ckplay
competitiveness is more than just supply and demand. like neo said, it also depends on the quality of the applicant pool. unless nrmp release board scores, aoa, grades, etc., there's no way to objectively compare

Obviously, but this does not detract from the point that your listing of the number of people who matched to each specialty in your class was completely asinine.

Originally posted by ckplay
it's been roughly 3 applicants to 1 position. but, again, this is probably a more select group of applicants.

You just implied that that information about candidates stats. is not published, so what is the basis for "a more select" group applying to derm?

Anyway, I am not saying that derm isn't competitive, It may be more competitive than rads. I am taking issue with your comment that rads is overrated, a point you have totally failed to sustain.

 

[ckplay]

you know, it's really stupid for you to get too analytical. i said rougly 1 in 3 from what i've been told...if you want the exact number, you can look it up yourself.

it's my opinion base on what i know about my classmates that rad is not at the level of derm in terms of competitiveness . do i need to analyze the stats to know that rad is more competitive than family practice?

you can disagree but don't be a prick.

 

[otohnsmdphd]

I think neo's point is very important. You can't really look simply at # applicants to # positions because one applicant pool will not have the same attributes as another. Some people in my 4th year class who wanted to go into fields such as dermatology or radiation-oncology were actually advised not to apply based on their non-competitive board scores, grades, etc. Although a subspecialty like neurosurgery may not look as competitive as radiology simply based on #applicants to #positions, the fact that 25% of matched neurosurgery spots this year went to MD/PhD applicants and 20% are AOA demonstrates that the applicant pool has already been "pre-selected" in a manner of speaking.

Anyway, interesting thread.

 

[LDSdoc]

Hi, if nothing else ya'll have pointed out to me just how difficult of a question it is that I asked.
What I really want to know is a little more specific about certain fields. For example, sometime in the next couple of months, I need to decide between Emergency, OB/GYN, General Surgery, Anestesiology, or Family Practice. I would be happy in any of them but I'd rank my preference in that order. I consider myself a "less competitive" applicant so it is important to me to know what you feel the trend is in these areas.
I noticed that ER has been pretty competitive in recent history but the match numbers seem to have dropped off this year. On the other hand, Anestesiology has been the opposite and it's match rate has really jumped this last year.
There are some programs that tend to not fill all of their spots consistently over the years even though it is considered a competitive residency. Drew in California for example seems to always have a few unfilled ER spots. Is that because they are giving their spots to other departments or because they would rather not fill than dip lower in the bucket or because it's a war zone and they can't fill all the spots?
Does a less competitive male have much of a shot in OB now-a-days?
Anyway, things like this. It was nice to read about the path and radiology though. It confirmed what I've seen in the general trends. I just don't know if the trends that I'm seeing in the above fields are real or just a manifestation of something else happening behind the scenes.

Thanks!

 

[LDSdoc]

Also, I was looking for an updated version of the Residency comparison list found at:

http://umed.med.utah.edu/residency/Specialties.html

It is pretty useful but, as you can see, it's out of date since 1998.

Thanks

 

[anonymousEM]

I agree with Dr. Cuts that you CAN match in EM as a US Grad even if you don't feel you're that competitive if you do the right things now (Which would still mostly apply if you decide some other field is your first choice):

1) Get to know the PD at your school's program (assuming there is one) if possible and do EXCELLENTLY on your rotation at your school. Perhaps you could even spend some time in the ED before this rotation at the end of 3rd year...make your interest known and get to know the residents and faculty.

1b) Do EXCELLENTLY on your away rotation (at a place you'd like but also realistically could get into--don't waste it on a place that will let you rotate but not give you an interview) and get to know the PD there...be assertive in trying to work shifts/meet with this person so that you'll be able to get a letter.

2) Get a virtual advisor from SAEM at www.saem.org to give you another perspective

3) If you didn't do well on step 1 consider rocking step 2 and having that score available for eras (take by mid-sept)--see debate on this on the EM thread

4) If you don't have to be in a certain city, appy broadly and to all types of programs (Community, County, University)...don't hesitate to send out a few more apps on ERAS--in the end an extra 45 bucks is a small price to pay for a match in something you really want!

Good luck...it only takes one to match!

 

[Hop Toad]

I am a top student at a "middle" med school - top 40 US News. Junior AOA, Step 1 over 265.

Question - how much will the lower ranked med school hurt me at a VERY top residency program? Interested in IM - Cards.

I have been burned before with excellent med school grades and not even getting interviews at Harvard or Cornell. Wait lists that did not clear at 2 other top 5 programs.

Does the snobbery still hold even with top national board scores?

People on these boards seem to get annoyed when others with good numbers ask questions, but as I make my list of where to apply for interviews, I'd like some honest input on how much not coming from a top med school will hurt my chances this time around.

Thanks.

 

[Foxxy Cleopatra]

Originally posted by Hop Toad
I am a top student at a "middle" med school - top 40 US News. Junior AOA, Step 1 over 265.

Question - how much will the lower ranked med school hurt me at a VERY top residency program? Interested in IM - Cards.

I have been burned before with excellent med school grades and not even getting interviews at Harvard or Cornell. Wait lists that did not clear at 2 other top 5 programs.

Does the snobbery still hold even with top national board scores?

People on these boards seem to get annoyed when others with good numbers ask questions, but as I make my list of where to apply for interviews, I'd like some honest input on how much not coming from a top med school will hurt my chances this time around.

Thanks.

I'm from an average public med school and I'm pretty sure it is not ranked! I was not AOA but I did well on the boards. I applied for general surgery this past year and got interviews at all but one place I applied (including some "top-tier" places.) I matched at my #2, a large state university program.

I found a little bit of snobbery regarding not being from a big-named medical school, but honestly, not all that much. Plus, with internal medicine, many of the big-named programs offer in excess of 30-40 categorical positions. You'll probably get interview offers to most places that you apply. If you interview well and rank enough of the top-tier places, I think it's pretty likely that you will get into to one of them for IM.

 

[Brewster]

Originally posted by Hop Toad

I have been burned before with excellent med school grades and not even getting interviews at Harvard or Cornell. Wait lists that did not clear at 2 other top 5 programs.

I assume you mean that you got burned with excellent undergrad grades...but you know what they say about when one assumes...

I would not worry about it too much. Your board scores are outstanding and junior AOA is a huge deal. Now your best bet is to get good letters from your home school and do 1-2 away rotations are programs you are interested in. You may be "shut out" of a couple programs due to snob factors, but most PDs will see past it all, recognize you as an outstanding candidate, and you will be on your way.

Just one man's opinion.

 

[urmdoc]

How competitive are psychiatric residencies at the top schools (places like Duke University), I went to med school and did undergrad at places that weren't great and would love to do a residency at a top program.

 

[RussianJoo]

How competitive are psychiatric residencies at the top schools (places like Duke University), I went to med school and did undergrad at places that weren't great and would love to do a residency at a top program.

so you just want to do a psych residency because you'll be able to match at a top notch place? that's the worst reason for picking a specialty that i've ever heard. you should do something you love not based on where you can do your residency.

 

[Medstudentquest]

rad is over-rated. a couple of guys in my class matched rad with so-so numbers.

I would agree with this. Many mediocre students at my school matched with crappy-mediocre numbers. Then again, someone who was quite qualified failed to match into neurology. So who knows!

Competitiveness really depends on too many factors.

 

[Octagonecology]

wow, a gap of 6 full years between posts. that i have never seen.

 

[DrJosephKim]

Remember that competition is also largely geographic. If you're in a metropolitan area, then you face a different level of competition compared to rural areas, the south, etc.

 

[Paddington]

I could be wrong, but my general impression though is that there's a fair number of guys with average to below average board scores, no research, and roughly "C" average performance in medical school who get into Radiology. In Dermatology, it's much tougher to break through if you don't have high board scores, honors in 4/6 core rotations, as well as some research to boot.

Most competitive: Dermatology, Plastic Surgery

Least competitive: Family Medicine, Psychiatry

 

[medsRus]

I could be wrong, but my general impression though is that there's a fair number of guys with average to below average board scores, no research, and roughly "C" average performance in medical school who get into Radiology. In Dermatology, it's much tougher to break through if you don't have high board scores, honors in 4/6 core rotations, as well as some research to boot.

Most competitive: Dermatology, Plastic Surgery

Least competitive: Family Medicine, Psychiatry

Agreed...

 

[Resuscitator]

Competition usually occur in the competitive states where more than 70% of IMGs apply which are know as the eastern states (NY, NJ, PA........), however if you moved to the western staes where a big number of positions will be available for scrambling (AL, AK, AR, AZ, CA, CO, ID, KS, LA, MN, MO, MS, MT, ND, NE, NM, NV, OK, OR, SD, TN, TX, UT, WA & WY) you may even match deramtology with no significant difficulty.

 

[Winged Scapula]

Competition usually occur in the competitive states where more than 70% of IMGs apply which are know as the eastern states (NY, NJ, PA........), however if you moved to the western staes where a big number of positions will be available for scrambling (AL, AK, AR, AZ, CA, CO, ID, KS, LA, MN, MO, MS, MT, ND, NE, NM, NV, OK, OR, SD, TN, TX, UT, WA & WY) you may even match deramtology with no significant difficulty.

Huh? California is one of the most competitive states. Competition is not generally related to the number of IMGs applying for positions except in terms of sheer numbers of applications a program receives.

As a matter of fact, for programs unlikely to take an IMG, competition would be less for an AMG in those states that receive significant number of apps from non-US educated students.

 

[josehernandez94]

How competitive are psychiatric residencies at the top schools (places like Duke University), I went to med school and did undergrad at places that weren't great and would love to do a residency at a top program.

in general, psychiatry is not a competitive field and people with average grades, board scores, etc can generally match at good programs. that said, if you're looking for a top-15 or 20 program, (eg the harvard programs, columbia, cornell, yale, pitt, etc, etc), you should have a competitive application. 230+ step 1, excellent clinical grades, excellent LORs, +/-aoa, +/- research depending where you're applying (eg mgh values research highly) is what you'll need to be competitive. of course, they're not like the elite derm or plastic surgery programs in terms of competitiveness, but they're still tough. it's probably worthwhile to point out that program directors also probably more willing to overlook one area of deficiency--eg if you have great grades and LORs but crappy board scores--they'll at least give you an interview, whereas that wouldn't be the case in things derm or plastics. and that's not to say that these are the only good programs--i think there are quite a few excellents ones in psychiatry--but you specifically asked about top programs, and that's the impression i have.