Top 10 Most Competitive Medical Specialties in 2024

May 8, 2024
4 min read


Reviewed by:

Jonathan Preminger

Former Admissions Committee Member, Hofstra-Northwell School of Medicine

Reviewed: 5/8/24

What are the most competitive medical specialties? Keep reading to learn more about the top 10 most sought-after fields.

In the dynamic landscape of healthcare, choosing the right medical specialty can significantly impact your career trajectory. As of 2024, some areas of medicine stand out as particularly competitive, attracting ambitious individuals with a passion for making a difference in patients' lives. 

If you’re looking for the perfect medical residency tailored to you, you’ve come to the right place. We’ve packed it with useful information that will help you understand the ins and outs of these challenging medical areas.

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How We Determined the Rankings of Medical Specialties

Ranking the most competitive medical specialties is a complex task that requires careful analysis of various data points. To create this comprehensive guide, we have relied on the most recent data available from reputable sources in the medical field, including:

  1. The Physician Compensation Report by Doximity.
  2. The 2024 Match Summary for MD Seniors, released by the National Resident Matching Program (NRMP).
  3. The latest 2024 Match Results by State, Specialty, and Applicant Type by the NRMP.

Determining the most challenging residency to match into is a layered process that takes into account various elements, such as the average USMLE Step 2 CK scores of matched applicants, the number of available positions in each specialty, and the overall volume of applications received. By examining these key metrics and considering other relevant factors, we can provide you with a well-rounded assessment of the competitiveness of each medical specialty.

The Top Most Competitive Specialties in Medicine

In the following section, we will explore the top 10 most competitive medical fields and specialties, providing insights into the factors that make them highly sought after by medical professionals.

1. Plastic Surgery

  • Match Rate: 100%
  • Number of Programs: 92
  • Number of Positions Offered: 213
  • Number of Applicants: 362
  • Average USMLE Step 2 CK Score: 257
  • Average Salary: $571,373 

Plastic surgery has always been a highly competitive field, and that trend shows no signs of slowing down in 2024. This specialty requires a blend of technical skill, artistic vision, and interpersonal finesse. Plastic surgeons must be able to perform complex reconstructive procedures as well as cosmetic enhancements, all while managing patients' expectations and emotions.

One reason plastic surgery is so competitive is the limited number of training spots available. There are only around 150 plastic surgery residency positions in the United States each year, and competition for these spots is fierce. Candidates often need to have exceptional academic records, research experience, and letters of recommendation to even be considered.

But for those who do make it through the rigorous training process, the rewards can be significant. Plastic surgeons have the opportunity to transform patients' lives, whether it's reconstructing a face after a traumatic injury or helping someone feel more confident in their appearance. They also tend to have high earning potential and a good work-life balance, making it an attractive specialty for many doctors.

2. Dermatology

  • Match Rate: 100%
  • Number of Programs: 14
  • Number of Positions Offered: 30
  • Number of Applicants: 295
  • Average USMLE Step 2 CK Score: 257
  • Average Salary: $468,509

Dermatology is another field that has seen a surge in popularity in recent years. This specialty focuses on the diagnosis and treatment of conditions affecting the skin, hair, and nails. Dermatologists may treat everything from acne and eczema to skin cancer and autoimmune disorders.

One reason dermatology is so competitive is the lifestyle it offers. Dermatologists typically have regular office hours and don't have to take calls or work overnight shifts. They also have the opportunity to perform a wide range of procedures, from biopsies and excisions to laser treatments and cosmetic injections.

But dermatology is also a challenging field that requires a deep understanding of complex medical conditions. Dermatologists must be skilled at recognizing subtle changes in the skin and knowing when to refer patients for further testing or treatment. They also need to have excellent communication skills to educate patients about their conditions and treatment options.

3. Orthopedic Surgery

  • Match Rate: 99.9%
  • Number of Programs: 218
  • Number of Positions Offered: 916
  • Number of Applicants: 1,492
  • Average USMLE Step 2 CK Score: 256
  • Average Salary: $624,043

Orthopedic surgery is a specialty that focuses on the diagnosis and treatment of conditions affecting the musculoskeletal system, including bones, joints, ligaments, tendons, and muscles. Orthopedic surgeons may treat everything from sports injuries and fractures to arthritis and spinal disorders.

One reason orthopedic surgery is so competitive is the wide range of procedures and subspecialties it encompasses. Orthopedic surgeons may specialize in areas like hand surgery, pediatric orthopedics, or sports medicine. They may also use cutting-edge techniques like minimally invasive surgery and robotic-assisted procedures.

Orthopedic surgery is also a field that offers a good work-life balance and high earning potential. Many orthopedic surgeons are able to maintain a regular schedule and have time for family and personal interests. And with the aging population and increasing demand for joint replacements and other orthopedic procedures, job prospects in this field are expected to remain strong.

4. Interventional Radiology

  • Match Rate: 98%
  • Number of Programs: 28
  • Number of Positions Offered: 51
  • Number of Applicants: 293
  • Average USMLE Step 2 CK Score: 253
  • Average Salary: $503,564

Interventional radiology is a relatively new specialty that has seen tremendous growth in recent years. This field involves the use of minimally invasive, image-guided procedures to diagnose and treat a wide range of conditions. Interventional radiologists may perform everything from biopsies and angioplasties to cancer treatments and pain management procedures.

One reason interventional radiology is so competitive is the rapid pace of technological advancement in this field. Interventional radiologists must stay up-to-date on the latest imaging techniques and treatment options, and be skilled at using complex equipment like CT scanners and fluoroscopes.

Interventional radiology is also a field that offers a good work-life balance and the opportunity to have a significant impact on patient care. Many procedures can be performed on an outpatient basis, allowing patients to recover quickly and avoid lengthy hospital stays. And because interventional radiology is often used as an alternative to more invasive surgeries, it can help reduce complications and improve outcomes for patients.

5. Anesthesiology

  • Match Rate: 100%
  • Number of Programs: 178
  • Number of Positions Offered: 1,695
  • Number of Applicants: 3,034
  • Average USMLE Step 2 CK Score: 240
  • Average Salary: $431,500

Anesthesiology is a highly competitive field that plays an important role in ensuring patient safety and comfort during surgical procedures. Anesthesiologists are responsible for administering anesthesia, monitoring vital signs, and managing pain before, during, and after surgery.

The competitiveness of this specialty stems from the high level of responsibility and the need for quick decision-making skills in critical situations. Anesthesiologists must have a deep understanding of pharmacology, physiology, and the complex interactions between anesthetics and the human body.

In addition to their role in the operating room, anesthesiologists are also involved in pain management, critical care, and research. The field is constantly evolving with advancements in technology and techniques, requiring anesthesiologists to stay up-to-date with the latest developments.

The demand for skilled anesthesiologists is expected to grow as the population ages and the number of surgical procedures increases. This, combined with the challenging nature of the specialty, makes anesthesiology one of the most competitive fields in medicine.

6. Thoracic & Cardiac Surgery

  • Match Rate: 100%
  • Number of Programs: 34
  • Number of Positions Offered: 48
  • Number of Applicants: 114
  • Average USMLE Step 2 CK Score: 254
  • Average Salary: $706,775

Thoracic surgery is a specialty that focuses on the surgical treatment of conditions affecting the chest, including the lungs, esophagus, and heart. Thoracic surgeons may treat everything from lung cancer and emphysema to esophageal disorders and congenital heart defects.

One reason thoracic surgery is so competitive is the high stakes involved. Many of the conditions treated by thoracic surgeons are life-threatening, and the surgeries themselves can be complex and risky. Thoracic surgeons must be able to make quick decisions under pressure and have the technical skills to perform delicate procedures on vital organs.

Thoracic surgery is also a field that is seeing rapid advancements in technology and technique. Minimally invasive procedures like video-assisted thoracoscopic surgery (VATS) and robotic-assisted surgery are becoming more common, allowing for faster recovery times and fewer complications for patients.

7. Otolaryngology

  • Match Rate: 99.7%
  • Number of Programs: 138
  • Number of Positions Offered: 382
  • Number of Applicants: 422
  • Average USMLE Step 2 CK Score: 257
  • Average Salary: $488,533

Otolaryngology, also known as ENT (ear, nose, and throat), is a specialty that focuses on the diagnosis and treatment of conditions affecting the head and neck. ENT doctors may treat everything from ear infections and hearing loss to sinus disorders and throat cancer.

One reason ENT is so competitive is the wide range of procedures and technologies it involves. ENT doctors may perform everything from tonsillectomies and ear tube insertions to complex head and neck surgeries. They also use advanced diagnostic tools like CT scans and endoscopes to visualize and treat hard-to-reach areas.

ENT is also a field that offers a good balance of medical and surgical practice. ENT doctors may spend part of their time seeing patients in the clinic and part of their time performing surgeries in the operating room. This variety can be appealing to doctors who enjoy both patient care and hands-on procedures.

8. Internal Medicine — Pediatrics

  • Match Rate: 100%
  • Number of Programs: 77
  • Number of Positions Offered: 390
  • Number of Applicants: 644
  • Average USMLE Step 2 CK Score: 250
  • Average Salary: $293,894

Internal medicine-pediatrics, also known as med-peds, is a specialty that combines the care of adults and children. Med-peds doctors complete a four-year residency program that includes training in both internal medicine and pediatrics, allowing them to provide comprehensive care to patients of all ages.

One reason med-peds is so competitive is the breadth of knowledge and skills required. Med-peds doctors must be able to diagnose and treat a wide range of conditions in both adults and children, from common illnesses like colds and flu to complex chronic diseases like diabetes and heart disease.

Med-peds is also a field that offers a lot of flexibility and variety in practice. Med-peds doctors may work in a variety of settings, from private practices and community health centers to academic medical centers and hospitals. They may also choose to specialize in areas like adolescent medicine, sports medicine, or global health.

9. Vascular Surgery

  • Match Rate: 99%
  • Number of Programs: 79
  • Number of Positions Offered: 100
  • Number of Applicants: 163
  • Average USMLE Step 2 CK Score: 250
  • Average Salary: $557,632

Vascular surgery is a specialty that focuses on the diagnosis and treatment of conditions affecting the blood vessels, including arteries, veins, and lymphatic vessels. Vascular surgeons may treat everything from varicose veins and deep vein thrombosis to aneurysms and peripheral artery disease.

One reason vascular surgery is so competitive is the complexity of the procedures involved. Vascular surgeons must be skilled at performing delicate surgeries on small, fragile blood vessels, often using minimally invasive techniques like endovascular surgery. They also need to have a deep understanding of vascular anatomy and physiology.

Vascular surgery is also a field that is seeing increasing demand due to the aging population and rising rates of conditions like diabetes and obesity. As more people develop vascular problems, the need for skilled vascular surgeons is expected to grow.

10. Neurological Surgery

  • Match Rate: 100%
  • Number of Programs: 148
  • Number of Positions Offered: 878
  • Number of Applicants: 423
  • Average USMLE Step 2 CK Score: 252
  • Average Salary: $788,313

Neurosurgery is often considered one of the most demanding and competitive specialties in medicine. This field involves the surgical treatment of conditions affecting the brain, spine, and nervous system. Neurosurgeons may treat everything from brain tumors and aneurysms to spinal cord injuries and congenital defects.

To become a neurosurgeon, doctors must complete a rigorous training program that typically lasts seven years after medical school. During this time, they learn complex surgical techniques and how to make split-second decisions in high-pressure situations. They also need to have a deep understanding of neuroanatomy and physiology.

Neurosurgery is a field that attracts some of the brightest and most ambitious doctors. It offers the opportunity to work on the frontiers of medical science and to have a profound impact on patients' lives. But it also requires a level of dedication and sacrifice that not everyone is willing to make.


The following FAQs provide answers to common questions about medical specialties, including competitiveness, difficulty, demand, and more.

1. What Is the Most Competitive Medical Specialty?

While competition levels can vary, plastic surgery often ranks as the most competitive medical specialty. Entering plastic surgery can be exceptionally challenging due to the need for both surgical skill and aesthetic judgment, combined with a limited number of available training positions.

2. What Is the Most Difficult Medical Field?

Fields such as neurosurgery and thoracic surgery are frequently mentioned because of the complexity and critical nature of their procedures. However, the difficulty of a medical field can be subjective and depends on personal aptitudes and interests. 

3. Which Medical Specialty Has the Highest Demand?

Demand for medical specialties varies with technology, disease trends, healthcare policies, and population changes. Primary care physicians are in high demand for their role in preventive care and managing chronic illnesses, reflecting the need for accessible healthcare. 

The aging population and increasing chronic diseases boost the demand for internists who treat adult health comprehensively. Psychiatrists also see rising demand due to greater mental health awareness and decreasing stigma, underscoring their essential role in mental health care.

4. What Is the Least Competitive Medical Specialty?

Demand for medical specialties fluctuates, making it hard to single out the least demanded universally. Pathology, nuclear medicine, and allergy and immunology are seen to have lower demand.

Despite this, the expertise of pathologists remains crucial for diagnosis and treatment planning, while nuclear medicine competes with more accessible imaging techniques. Allergy and immunology's demand varies, as many conditions can be managed without specialist intervention. 

Final Thoughts

The realm of the most competitive medical specialties is constantly evolving, shaped by factors such as technological advancements, societal needs, and healthcare trends. Aspiring medical professionals should weigh their choices carefully, considering not just the competitiveness of these specialties but also their own personal interests and strengths. 

Whether you’re drawn to the intricate art of plastic surgery or the community-oriented role of a family physician, pursuing a career in any of these fields demands strong dedication, resilience, and continuous learning. Though demanding, this journey offers immense satisfaction and the opportunity to make a significant impact in the field of healthcare.

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