What ARE the most competitive residencies?

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People talk and talk about how important it is to go to the very best med schools to get into the most competitive residencies, but the residencies themselves are questionable.

So, in your opinions, what are the most competitive residencies?? I know derm is up there, as is ortho.
What are the other ones?

For example, I'm currently planning on either going into neurology or cardiology. Would those be among the more competitive residencies?

ps.- it would be PARTICULARLY helpful if when listing the residencies you could mention how many years they are, for the noobs.
 
Cardiology is not a residency but a subspecialty of Internal Medicine that is entered by finishing a residency in that field and applying for a fellowship. It is among the most competitive Internal Medicine fellowships.

Neurology is not competitive.

In my mind, the most competitive fields are

Derm
Integrated Plastics
ENT
Radiation Oncology
 
ROAD and ortho, plastics, and Ent surg

but by the time your there it will completley different anyways except maybe plastics
 
your forgetting optho, not to mention plastics

Emergency Medicine 3-4 years

Family Practice 3 years

Internal Medicine 3 years

Pediatrics 3 years

Obstetrics-Gynecology 4 years

Pathology 4 years

Psychiatry 4 years

General Surgery 5 years

Neurological Surgery 6 years (includes 1 year of general surgery)

Orthopaedic Surgery 5 years (includes 1 year of general surgery)

Otolaryngology 5 years (includes 1 year of general surgery)

Urology 5 years (includes 1 year of general surgery)

Plastic Surgery 5-6 years (includes 3 years of general surgery)

Anesthesiology 3 years plus PGY-1 Transitional/Preliminary

Dermatology 3 years plus PGY-1 Transitional/Preliminary

Neurology 3 years plus PGY-1 Transitional/Preliminary

Ophthalmology 3 years plus PGY-1 Transitional/Preliminary

Physical Medicine 3 years plus PGY-1 Transitional/Preliminary

Diagnostic Radiology 4 years plus PGY-1 Transitional/Preliminary

Radiation Oncology 4 years plus PGY-1 Transitional/Preliminary

Transitional/Preliminary 1 year
 
planning your residency already is funny.
 
TehDoc said:
planning your residency already is funny.
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I already know where im going to work, how much im going to make, and how many kids im going to have by the time im 40. I also know when the real-estate bubble will burst and who the next president will be.
 
Tyc00nman said:
I already know where im going to work, how much im going to make, and how many kids im going to have by the time im 40. I also know when the real-estate bubble will burst and who the next president will be.
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LOL, nice one.:meanie:
 
TehDoc said:
planning your residency already is funny.
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Some of the turbo pre-meds actually know what specialty they want to pursue at this time. They tend to be the ones that actually read countless articles, shadow doctors for countless hours, and have parents in the specialty they are interested in. Your typical pre-med does not have any idea what kind of specialty they want to go into, but turbo pre-meds definitely do.
 
TehDoc said:
planning your residency already is funny.
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I picked my fellowship of choice when I was in college and I'm still on that track. There's nothing wrong with having concrete goals. Better in my mind than the med school applicants who claim to be equally likely to go into all fields -- why would you go to medical school if you have zero idea about what you want your career to be like when you're done with education?

If those goals happen to involve something competitive, it is best to start thinking about how to get there early.
 
TehDoc said:
planning your residency already is funny.
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Indeed.

Why is ENT so competitive? It seems like kind of a boring specialty. Is it because there are a limited number of spots, or too many people applying?
 
metalgearHMN said:
Indeed.

Why is ENT so competitive? It seems like kind of a boring specialty. Is it because there are a limited number of spots, or too many people applying?
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Limited number of residency spots, similar to derm. Limited training spots also means that your job market is not oversaturated when you are done training.

Our current reimbursement system favors short procedures, of which many can be done in a day.

For a surgical field, ENT has good lifestyle both in residency and in the real world.

It also offers a good mixture of OR and clinic, which many find appealing.
 
Geriatric proctology is a pretty hot field right now I've heard
 
Residency competition data is great for cross-referencing with match lists to get a general idea of a school's match-competitiveness.

Thanks!
 
harposnarpo said:
Residency competition data is great for cross-referencing with match lists to get a general idea of a school's match-competitiveness.

Thanks!
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I actually think it's horrible for this purpose. You have no idea how many people wanted to go into a competitive field.

Many people at the top of my class went into family medicine despite being competitive for any field. Of the 3 people who were awarded for having the highest grades, 2 are going into Peds. Conversely, no one in my class applied to derm. At a more expensive school, there may have been more demand for specialties with high reimbursement, but many here had the luxury of choosing from all fields.

Much of competitiveness also has to do with the number of training spots available, and not how good that field actually is. If you reduced Pediatrics to 300 spots like Derm, it would probably be just as competitive.

Looking at our match list from the competitive-specialty angle, you'd think we were pretty pathetic. But 99% got the field they wanted, and mostly at their top choice or #2.
 
WinterLights said:
Some of the turbo pre-meds actually know what specialty they want to pursue at this time. They tend to be the ones that actually read countless articles, shadow doctors for countless hours, and have parents in the specialty they are interested in. Your typical pre-med does not have any idea what kind of specialty they want to go into, but turbo pre-meds definitely do.
Click to expand...

Hehe, yes, and you can spot the turbo pre-meds because they have built in jet engines which they are constantly fueling with top notch gasoline (they try to tell me it's coffee, but I have my suspicions..) as they jet between their various activities.

Just kidding 🙂 I'm just another relatively clueless premed, I have no idea what specialty I want to pursue yet. I'm more of the "one step at a time" kind of person, haha, let's pass anatomy, and then step 1, survive the first few rotations, and then we can start thinking about specialties..
 
WinterLights said:
Your typical pre-med does not have any idea what kind of specialty they want to go into, but turbo pre-meds definitely do.
Click to expand...

I don't know about that. I'm kinda interested in EM, maybe doing a fellowship in emergency pediatrics, or IM, or maybe some kind of surgery, general, urology, transplant? Addiction medicine also sounds cool. I mean, I'm pretty sure I will end up in one of those. Maybe. Or not.
 
harposnarpo said:
Residency competition data is great for cross-referencing with match lists to get a general idea of a school's match-competitiveness.

Thanks!
Click to expand...

I agree with lord jebus -- this doesn't tell you what you think. First, you can't possibly know what the better residencies sites are for each specialty (they often don't jibe with US News-type rankings, and won't all be the same), so the match list part of it is flawed from the start. Do you know what the better optho programs are? rads? derm? The list of good versus malignant is very different for each, and driven more by the personnel there than the school name. There are some very good schools with some very bad specialty departments.

But assuming arguendo you get past that hurdle (which is impossible for a premed because it requires word of mouth input from academic medical professionals in each field), you then have to address jebus' argument. It's not like applying to college or med school where people just go to the "best" place they can get. They go into what they "want" to do for a living. So it's pretty common for the top student in a med school class to go into internal medicine or general surgery (not particularly competitive) rather than derm or plastics. It's common to see schools where nobody matches into derm or plastics because none of the people who could get it wanted it. You will meet amazing med students who go into peds because they love kids, or OBGYN because they are focused on women's issues, or psych or neuro because these are interesting to them. People don't say, I can get into a competitive residency, so that is what I'm going to do. They say, what is it I enjoy doing. This is something that you can never get at in a match list, and so it kills any analysis where you compare competitive residencies and matches -- you are assuming choices that aren't in fact being made. You can't just say this school had 10 matches into derm at MGH so it must be better than this other one that had 5 because it ignores the fact that the latter school might have had another couple dozen that could have gotten derm if that was their interest. It's all about what folks want to do for a living at this stage. And there are lots of choices based on factors other than competitiveness. So the data doesn't even give you the rough general idea you think.

And a lot of people also do their residencies based on location (folks may not want to uproot families, might want to stay close to family, may want to stay near where they grew up, etc), rather than relocate to XYZ hospital which is the objectively "best" residency they could get. Some people even do a less competitive path that ensures them staying put. So that also throws off any ability to analyze what people could get into.

The real issue is going to be "did people get what they wanted" and this is really an impossible thing to know without talking to them. I wouldn't waste time with such analysis because it is drastically flawed, and sure wouldn't go around calling it "great". It's not.
 
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2 Questions:

Hows the lifestyle of a plastic surgeon? Is it comparably as busy as other surgeons?

How many residencies can or do people usually apply too?
 
lord_jeebus said:
I picked my fellowship of choice when I was in college and I'm still on that track. There's nothing wrong with having concrete goals.
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There's even LESS wrong with keeping your options open.

lord_jeebus said:
Better in my mind than the med school applicants who claim to be equally likely to go into all fields.
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Why? I consider myself to be interested in a lot of different fields but according to you, I'm not as good an applicant as you were specifically b/c I dont know what field I want to go into? How would I? You don't think there's a VERY large chance that kids who "know" what specialty they want to go into won't change their minds once they're actually in medical school?

lord_jeebus said:
-- why would you go to medical school if you have zero idea about what you want your career to be like when you're done with education

If those goals happen to involve something competitive, it is best to start thinking about how to get there early.
Click to expand...

Its possible to be interested in medicine itself and not just specialties.
 
Next time you see your proctologist, be sure to give him/her an anal wink.🙂
 
Oh, I'm absolutely open-minded. I spent years thinking I wanted to go into ophthalmology, then loved working with a laryngologist, and loved working with a psychiatrist, loved working with a cardiologist...and I was a neuroscience major and want to become Oliver Sacks, so neurology has always been one of my favorites. I'm really excited about figuring out what I want to do, actually....I'm just curious about what the "most competitive" fields are and how long it takes to get there.
 
bawer234 said:
There's even LESS wrong with keeping your options open.

Why? I consider myself to be interested in a lot of different fields but according to you, I'm not as good an applicant as you were specifically b/c I dont know what field I want to go into? How would I? You don't think there's a VERY large chance that kids who "know" what specialty they want to go into won't change their minds once they're actually in medical school?

Its possible to be interested in medicine itself and not just specialties.
Click to expand...

I have been on an adcom and all I can say is that people who know what they're getting themselves into usually have some sort of idea of what parts of medicine seem more attractive than others.

It's hard to make the case that "I know for sure that I want to be a doctor but I don't have any idea if I'd rather be a psychiatrist or a trauma surgeon." You are not expected to have sampled the broad spectrum of medicine, but you should be able to point to specific aspects of what you have seen and how you want that for yourself.

Yes, people change their minds often, but you should have some basic insight into what you are looking for in a career and what kinds of medical careers might meet those needs.
 
lord_jeebus said:
I have been on an adcom and all I can say is that people who know what they're getting themselves into usually have some sort of idea of what parts of medicine seem more attractive than others.

It's hard to make the case that "I know for sure that I want to be a doctor but I don't have any idea if I'd rather be a psychiatrist or a trauma surgeon." You are not expected to have sampled the broad spectrum of medicine, but you should be able to point to specific aspects of what you have seen and how you want that for yourself.

Yes, people change their minds often, but you should have some basic insight into what you are looking for in a career and what kinds of medical careers might meet those needs.
Click to expand...

This is what I was hoping you meant. Your other post was just strongly worded and I wasn't sure how adament you were about "knowing" what area you're interested in. I can see why someone who has very specific medical interests might be more attractive to adcoms than a starry-eyed pre-med who doesn't even have a clue about what area of medicine they are even remotely leaning towards.
 
We're a bit off-topic now but

ejay286 said:
How many residencies can or do people usually apply too?
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You can apply to all of them if you want, but generally the norm is just one. If someone is applying to a very competitive specialty, or is a weak applicant, it is common to add a "backup" specialty.
 
I knew when i was 8 i wanted to be a doctor. People actually believe me now when i tell them i want to become a doctor, especially after the MCAT and pre med requirements are over.
 
lord_jeebus said:
We're a bit off-topic now but



You can apply to all of them if you want, but generally the norm is just one. If someone is applying to a very competitive specialty, or is a weak applicant, it is common to add a "backup" specialty.
Click to expand...

When you say one do you mean just one specialty but many different places within that specialty or do you mean just one period.
 
I looked at that WashU residency link and it showed that Emergency med's competitiveness is "low" for 08.....i always thought that EM was pretty competitive....is this a new trend or something? Is there some horrible thing happening in the EM world that is now deterring students?
 
ejay286 said:
When you say one do you mean just one specialty but many different places within that specialty or do you mean just one period.
Click to expand...

It means you usually apply to one specialty but to many different places. For example, people can apply to IM residencies in Cali, FL, NY, etc. all at the same time.
 
Textuality said:
Hehe, yes, and you can spot the turbo pre-meds because they have built in jet engines which they are constantly fueling with top notch gasoline (they try to tell me it's coffee, but I have my suspicions..) as they jet between their various activities.

Just kidding 🙂 I'm just another relatively clueless premed, I have no idea what specialty I want to pursue yet. I'm more of the "one step at a time" kind of person, haha, let's pass anatomy, and then step 1, survive the first few rotations, and then we can start thinking about specialties..
Click to expand...

Sweetie with your MCAT score and GPA on your MDApps and you going to UPenn's Med School, I doubt you are "another relatively clueless premed". LOL. The attitude of one thing at a time is a good way to go.
 
What do you mean by "competitive" is worth defining. Do you mean which residencies have the highest board scores and the most AOA members, or the residencies with the highest unmatched %?

For example, neurosurgery has insanely high board scores, but has a higher match % than some other specialties (derm) because people self-select out of it because of the lifestyle.

Anyway, seeing as how data is split between SFMatch and NMRP, then there are fellowships galore, this is a much harder question to answer than it may appear.

My top 5 list would go

1 Plastics
2/3 Neurosurgery , Derm
4/5 Rads , ophthalmology

Who said gas was competitive? the good programs may be, but matching into ANY program in anes is NOT difficult unless you went to Offshore U.

edit to say that, although NSGY is quoted as 6 years incl pgy1 above, many programs are seven years total (from PGY1 internship in gen surg to PGY7 chief resident)
 
There's an odd duality that exists as one transforms from a pre-med to a medical student: when interviewing for medical school, you're supposed to have shadowed a doc and be absolutely sure medicine is right for you; when you're a student, you're not supposed to have a clue of what you want to go into for the sake of being open-minded.

I have a pretty good idea of what I like, but I'm always open to suggestions.
 
what is PGY-1 Transitional/Preliminary?
 
HAHA at turbo pre-meds.
 
ar2388 said:
what is PGY-1 Transitional/Preliminary?
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Its like an intern year, but not as crazy. It's done prior to entering a specialized field. You'll get a grab-bag of experiences as you rotate through various services. Then in PGY (post-graduate year- 2) you start your specialized residency, example: a friend of mine matched into Radiology, but he is doing a transitional year before that. He's on a month of Cardiology at the moment.
 
i disagree somewhat with law2doc's post above. You can get a reasonable idea of how competitive matching is by looking at the match list. If you see lots of competitive specialties being picked, plastics, derm, ENT, urology, rads, etc, that's good. The other is if you see people in general specialties, FM, IM, Peds, matching at top academic institutions--that's also good. Anesthesia, as someone said above, you need to see where that person matched.

So, although people may pick the specialty they like best, they will usually pick amongst the "best" programs that are available within their specialty.

If someone picks their home institution, unless its a very good institution, it's kind of a wash. Difficult to say.
 
Strength&Speed said:
So, although people may pick the specialty they like best, they will usually pick amongst the "best" programs that are available within their specialty.
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Absolutely, but as a premed, you will have no idea whatsoever what the "best" programs are in a given specialty. It does not track USNews. It is largely based on word of mouth, culture and personnel -- as to whether a program is good versus malignant. Some of the big named schools have crummy programs in certain specialties, where everyone is unhappy and frequently making mass exoduses. No program is the best in every, or even most specialties. And the hierarchy of "best schools" is totally different for each specialty. So you are sunk by this approach as well. You simply lack this data until you pick a specialty and sit down with a mentor in that field and find out what places are good or not.

Thus, as I stated before, you neither (1) know what the best programs per specialty are and (2) don't know whether people are not going into competitive things because they don't get them or don't choose them. So your approach simply doesn't yield high dividends. It may not be totally useless if you knew a bit more about the goals of the applicants and actually knew the rankings within various specialties (which you won't), but certainly isn't a "great" approach as you asserted above, and I probably wouldn't waste my time with it. Sorry, but when people are choosing what they WANT to do for a living, looking at this kind of stuff simply leads you to the wrong conclusions more often than not.
 
Depakote said:
Its like an intern year, but not as crazy. It's done prior to entering a specialized field. You'll get a grab-bag of experiences as you rotate through various services. Then in PGY (post-graduate year- 2) you start your specialized residency, example: a friend of mine matched into Radiology, but he is doing a transitional year before that. He's on a month of Cardiology at the moment.
Click to expand...

Bear in mind that you HAVE to do a prelim year for many of the competitive residencies -- eg all the ROAD specialties. Thus you will be doing a year of medicine or general surgery if you choose one of these fields. It's just as crazy as the intern year -- in fact you are usually on the exact same schedule and teams as any other intern, and rotate through the same things, and the residents treat you exactly the same as any other intern. You may even be called the intern. The only difference is you know you are leaving in a year, so if you don't like it, at least it is finite.
 
Law2Doc said:
Bear in mind that you HAVE to do a prelim year for many of the competitive residencies -- eg all the ROAD specialties. Thus you will be doing a year of medicine or general surgery if you choose one of these fields. It's just as crazy as the intern year -- in fact you are usually on the exact same schedule and teams as any other intern, and rotate through the same things, and the residents treat you exactly the same as any other intern. You may even be called the intern. The only difference is you know you are leaving in a year, so if you don't like it, at least it is finite.
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Well, it depends on the program.

I'm in a prelim program and we have an almost completely different schedule from the categorical interns. Most of the time I'm at a different hospital with lighter patient load, with only 2 months total at the main university hospital where the categoricals suffer. Right now I'm working as hard as I did as an MS4!

Also, it goes without saying that if you do Transitional as your prelim, things are likely not going to be that crazy.
 
lord_jeebus said:
Well, it depends on the program.

I'm in a prelim program and we have an almost completely different schedule from the categorical interns. Most of the time I'm at a different hospital with lighter patient load, with only 2 months total at the main university hospital where the categoricals suffer. Right now I'm working as hard as I did as an MS4!

Also, it goes without saying that if you do Transitional as your prelim, things are likely not going to be that crazy.
Click to expand...

I'm not sure you can do a transitional year as your prelim for the competitive specialties. At least I was told you couldn't.
I have no doubt you are correct that the prelim program schedule depends on your program. But the folks I know in prelim years are "the intern" on their teams, and get treated the same.
 
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