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10 Most Competitive Medical Specialties in the United States
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10 Most Competitive Medical Specialties in the United States

Written by
International Medical AID
on March 22nd, 2025

READING TIME
9 minutes

Some students know what specialty they want to practice when they become doctors. They know long before medical school, while others decide or change their minds during those four years. You’ll want to choose your specialty carefully since a lot rides on it. This article discusses the most competitive medical specialties in 2022

To practice in a specialized field, you’ll need to get into a residency program to train for it. If you live in the United States or attend school in the United States, you might want a United States-based residency. Some residencies are fairly easy to get into, but many are quite difficult. Competing for the top residencies available requires a lot of hard work. You must score very well on USMLE Step 1 and USMLE Step 2 CK. 

In today’s article, we’re showing you the hardest medical specialties and the most competitive residencies. We hope this information inspires you and gives you food for thought regarding your own medical school journey. 

If you’re struggling to decide what specialty to choose, feel free to contact us. Our medical school admissions consulting team would be happy to discuss your career goals and aspirations with you. We also offer voluntary healthcare internships abroad. The hands-on experience that our internships provide can also help you decide on your medical specialty.

10 Most Competitive Medical Specialties

  1. Orthopedic Surgery
  2. Neurological Surgery
  3. Plastic Surgery
  4. Otolaryngology
  5. Dermatology
  6. Radiation Oncology
  7. Urology
  8. Ophthalmology
  9. Diagnostic Radiology
  10. General Surgery

#1 Orthopedic Surgery

Fast Facts:

  • 248 USMLE score
  • Overall Score: 28
  • Residency: five years + two years post-surgical
  • 239 applicants in the most recent Match

Orthopedic surgery is among the most competitive residencies in the United States. Orthopedic surgery focuses on musculoskeletal conditions like trauma, spine diseases, degenerative diseases, tumors and more. There were only 31 open positions for residency in the most recent Match, making it one of the hardest medical specialties out there. But while it’s extremely difficult to match, the salary is over $500K, and the career is very rewarding.

Most Competitive Medical Specialties

#2 Neurological Surgery

Fast Facts:

  • 245.5 USMLE score
  • Overall score: 27
  • Residency: at least seven years
  • 397 applicants in the most recent Match

Coming in at number two, neurological surgery is also among the most competitive residencies. Neurological surgery involves the central, peripheral and autonomic nervous systems, as well as nervous system, spinal cord and pituitary gland disorders. These types of surgeries can be life-changing for the patient and very fulfilling for the surgeon. No wonder it’s among the most competitive residencies! There were 232 spots open for medical students in the most recent Match. The salary ranges but generally stays in the $600k range.  

#3 Plastic Surgery

Fast Facts:

  • 248.5 USMLE score
  • Overall score: 26
  • Residency: six years
  • 291 applicants in the most recent Match

Plastic surgery is a newer medical field, but it’s already among the most competitive residencies out there. Plastic surgeons perform reconstructive and cosmetic surgery. Reconstructive surgery involves craniofacial surgery, hand surgery and treatment for burns. Cosmetic surgery involves improving or changing part of a patient’s physical appearance. There were 180 positions for future residents in the most recent Match. Plastic surgeons make over $400K annually.

#4 Otolaryngology

Fast Facts:

  • 250 USMLE score
  • Overall score: 25
  • Residency: five years + 51 months of progressive education
  • 505 applicants in the most recent Match

Otolaryngology specialists treat the ears, nose and throat. They’re commonly known as ear, nose and throat doctors (ENT). Otolaryngology is the oldest medical specialty in the United States. It dates all the way back to the 17th century! There were 350 positions for medical students to compete over in the most recent Match. ENTs make a little under $375K annually. 

Dermatology

#5 Dermatology

Fast Facts:

  • 251 USMLE score
  • Overall Score: 24
  • Residency: four years
  • 239 total applicants in the most recent Match

Dermatologists treat diseases that afflict the skin. Skin, hair, nails and cosmetic issues can all be resolved through dermatology. There were 31 open positions for dermatology residencies in the most recent Match. The salary is just over $400K annually. 

#6 Radiation Oncology

Fast Facts:

  • 244.5 USMLE score
  • Overall score: 23
  • Residency: four years
  • 169 applicants in the most recent Match

Radiation oncology is most commonly associated with cancer treatment. Radiation therapy controls and kills malignant cells. It’s part of the overall treatment for cancer patients, both for curative and palliative treatments. Radiation oncologists most commonly treat lung, breast, head and neck, prostate, cervix and uterus, and colorectal cancers. There were 192 open positions in the most recent Match. The salary is around $418K annually. 

#7 Urology

Fast Facts:

  • 238 Urologist rating (USMLE score unavailable)
  • Overall score: 22
  • Residency: five to six years, depending on sub-specialty
  • 484 applicants in 2020

Urology is the field of medicine that deals with urinary tract diseases in men and women. The kidneys, ureter, bladder and urethra are subject to diseases that urologists treat. They also treat the male reproductive system. Urology comes with seven sub-specialties:

  • Pediatric
  • Urologic
  • Renal
  • Male infertility
  • Urinary tract stones
  • Female urology
  • Neurourology

There were 354 positions in 2020, making urology a highly competitive field. Urologists are paid on average $380K per year.

#8 Ophthalmology

Fast Facts:

  • 244 USMLE score
  • Overall score: 20
  • Residency: five years + two years for sub-specialties
  • 635 applicants in the most recent Match

Ophthalmologists care for the eyes. They prescribe medication to treat eye diseases, and they perform laser therapy and laser surgery. Common eye diseases include cataracts, excessive tearing, glaucoma and macular degeneration. Ophthalmology is a very important medical field because vision is very important. Without ophthalmologists, many individuals would lose their vision or need to wear glasses permanently. There were 496 available spots for residency in the last Match. The average salary is $343K every year.

#9 Diagnostic Radiology

Fast Facts:

  • 245 USMLE score
  • Overall score: 20
  • Residency: four years
  • 1,232 applicants in 2020

Diagnostic radiology is known as “the eye of medicine” for good reason. Radiologists diagnose diseases using MRI scans, CT scans, nuclear medicine scans, X-rays and ultrasounds. Radiologists frequently use these scans to diagnose suspected diseases. A patient will generally exhibit symptoms, and the scan will be used to confirm the diagnosis. There were 1,146 positions in 2020. The salary averages $400K yearly. 

#10 General Surgery

Fast Facts:

  • 238.5 USMLE score
  • Overall score: 18
  • Residency: at least five years
  • 2,183 applicants in 2020

General surgery includes having a vast knowledge of the entire body. Surgeons perform complex surgeries at a moment’s notice. They often perform surgery on patients who come in through the ER. These are some of the areas that general surgeons work in.

  • Trauma surgery; there are specialties within trauma surgery, but general surgeons must know how to stabilize a patient who has suffered from severe trauma. These procedures include thoracostomy, cricothyroidotomy, compartment fasciotomies and emergency laparotomy or thoracotomy.
  • Laparoscopic surgery; general surgeons must know how to laparoscopically remove gallbladders, appendices and colons. Laparoscopic surgery involves inserting a camera and tools through a tiny incision (3 to 15mm). It’s a less invasive procedure than traditional surgery.
  • Colorectal surgery; these surgeries revolve around colon and rectal diseases, as well as diverticulitis, gastrointestinal bleeding and hemorrhoids.
  • Breast surgery; these breast surgeries are not cosmetic. They are usually for treating cancer.
  • Vascular surgery; general surgeons treat minor vascular disorders. More complicated procedures are performed by specialists.
  • Endocrine surgery; general surgeons receiving training to remove the thyroid, parathyroid and adrenal glands.
  • Transplant surgery; emergency transplant surgeries are often done by general surgeons. These surgeries include organ transplant patients.
  • Surgical oncology; general surgeons are trained to remove tumors.
  • Cardiothoracic surgery; most heart surgeries are performed by specialists, but general surgeons are trained to perform emergency surgeries.
  • Pediatric surgery; these surgeries are for children and can cover any of the surgeries listed above.

General surgery had 1,536 open positions in 2020. Salaries start at $360K yearly. 

Conclusion – Most Competitive Medical Specialties

Those are the 10 most competitive medical specialties in the United States in 2022. There are many other specialties to consider as well. If you need help deciding on your specialty, we invite you to check out our medical school admissions consulting. The experts on our team can help you find specialties that match your goals and career aspirations. The right specialty is out there for you!

Not in medical school quite yet? Still, deciding what school to attend? International Medical Aid is here to guide you. Check out the schools in our series of definitive guides to getting into medical school. We add more guides all the time, so be sure to check back often. Good luck on your medical school journey!

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#Admissions Consulting #Medical School Guides #Medicine #Pre-Medicine #Residency

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About IMA

International Medical Aid provides global internship opportunities  for students and clinicians who are looking to broaden their horizons and experience healthcare on an international level. These program participants have the unique opportunity to shadow healthcare providers as they treat individuals who live in remote and underserved areas and who don’t have easy access to medical attention. International Medical Aid also provides medical school admissions consulting to individuals applying to medical school and PA school programs. We review primary and secondary applications, offer guidance for personal statements and essays, and conduct mock interviews to prepare you for the admissions committees that will interview you before accepting you into their programs. IMA is here to provide the tools you need to help further your career and expand your opportunities in healthcare.