Residency & Beyond

10 Most Popular Residency Specialties

How does each medical student decide which specialty to apply to? Understanding these questions early in medical school, or even as a pre-medical student, can make this process easier and more successful.

First, we must define “popular”. One definition from Miriam Webster dictionary is: “suitable to the majority-frequently or widely accepted”. For this definition, we would compile the list of the 10 specialties with the most residents in training. By far, the top 2 would be Internal Medicine with 9,380 positions offered in 2022, and Family Medicine with 4,916 positions.

What Specialties Have the Most Availability for The Match?

According to the national residency match program (NRMP) 2022 report, these are the 10 residency specialties with the most positions offered, from highest to lowest:
1) Internal Medicine – 9,380 positions offered
2) Family Medicine – 4,916 positions offered
3) Pediatrics – 3,016 positions offered
4) Emergency Medicine – 2,921 positions offered
5) Psychiatry – 2,047 positions offered
6) Anesthesiology – 1,969 positions offered
7) Medicine-Preliminary – 1,774 positions offered
8) Surgery – 1,622 positions offered
9) Transitional – 1,616 positions offered
10) Obstetrics-Gynecology – 1,503 positions offered

Another definition of “popular” according to Miriam Webster is: “adapted to or indicative of the understanding and taste of the majority”. Per this second definition, we would compile the list of the 10 most competitive residency programs.

What Specialties Are Most Competitive?

Compiling a list of the most competitive specialties to match into is a bit more complicated. When it comes to determining the most competitive residency specialties, there is a myriad of ways to quantify this. One is looking at specialties where all program positions were filled during the match. This gives a list of specialties that are completely filled but does not discern among those which were more competitive. Other data from the NRMP used in determining competitiveness is the percentage of applicants in that specialty that match into a position; i.e. the lower the number, the more competitive the specialty. The flaw in this approach is the confounding effect of the numerator (number of applicants) and the denominator (number of positions).

Another option in quantifying competitiveness is from the perspective of which specialties had the highest number of allopathic vs. osteopathic vs. international medical graduates students match into that specialty. This perspective is also skewed as some highly qualified osteopathic or international students could be more competitive candidates than a lower caliber allopathic student.

What Specialties Require the Highest USMLE Scores?

The NRMP also has data on which specialties have the highest USMLE step 1 scores of those that match. This is not as helpful to quantify competitiveness going forward because of the recent transition of step 1 to pass/fail, which pushes the “triage” of students to the USMLE Step 2 CK score.

There is also data from the NRMP for the mean USMLE Step 2-CK scores of each specialty. Confounding the competitiveness endeavor further are those specialties that participate in their own separate match process: Neurology, Neurosurgery, Urology, Ophthalmology, Military, and Canadian match
processes. Some of this information is included with the NRMP data, but not all (Ophthalmology and Urology match results). Confusingly, there are also programs that match students into “categorical” vs. “preliminary” positions. Categorical positions are those that include the internship year with the specialty training years; preliminary programs are only the intern year and the specialty program is separate.

10 Most Competitive Specialties to Obtain a Residency Training Position

Finally, some plastic surgery programs only allow students to apply after 3 years of general surgery training. Ultimately, I decided to take into consideration as many of the preceding factors as possible in compiling the following list of the 10 most competitive specialties to obtain a residency training position.

1) Plastic Surgery
2) Otolaryngology
3) Dermatology
4) Orthopedic Surgery
5) Neurological Surgery
6) Interventional Radiology
7) Ophthalmology
8) Diagnostic Radiology
9) Urology
10) Obstetrics & Gynecology

According to the AMA, continuing a multi-year trend, the 2022 Main Residency Match included the largest number of total positions on record: 39,205. 36,277 of these were postgraduate year 1 (PGY-1) positions, a 3.1 percentage point increase over 2021. There were 42,549 active applicants, which means those applicants who submitted certified rank-order lists. At a rate of 80.1%, 34,075 active applicants matched PGY-1 positions, a 1.6 percentage point increase over 2021.

Do Some Specialties Offer More or Less Positions Year Over Year?

Some specialties that increased the number of positions offered in the Match in 2022 saw a drop in the percentage of positions filled compared to 2021:

  • Emergency Medicine-fill rate down 7.0 percentage points.
  • Family Medicine-fill rate is down 2.7 percentage points.
  • Internal Medicine-fill rate is down 0.7 percentage points.
  • Psychiatry-fill rate is down 0.6 percentage points.

Which specialty to choose and how to successfully obtain a residency position is complicated, challenging, and requires extensive mentoring and planning.

Can I Get Help Matching Into My Ideal Specialty?

One of the many services we provide at MedSchoolCoach is mentoring/guidance by a seasoned physician advisor on how to achieve your dream residency position, advice on elective rotations, letters of recommendation, etc.; in addition to assistance with the ERAS application process, construction of written materials (personal essay, activities, CV), program list creation, interview prep, rank list creation, etc.

Transform Your Match Prospects

We also provide a highly qualified writing advisor to make the written materials of this application as high quality as possible. Contact us at MedSchoolCoach.com for more information on this or any of the smorgasbord of services we provide for medical school and residency applications.

Blair Nelson MD

Dr. Blair Nelson graduated Summa Cum Laude from the University of North Dakota with a Bachelor of Science Degree in Psychology. He then worked as a rural ER doctor in Fargo, North Dakota and Detroit Lakes, Minnesota. During his years as an attending physician, he became director of medical education for his department and was named affiliate professor for the University of Minnesota and University of North Dakota medical schools. Dr. Nelson is an enthusiastic educator with many success stories assisting students obtaining entrance to medical school.

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