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Hardest And Easiest Medical Specialties

As if finishing medical school wasn’t already difficult enough, certain specialties are much harder to match into for residency compared to others. In a previous video, we went over the top 5 most competitive and difficult specialties to match into. Today, let’s cover the 6 least competitive specialties. (Originally published Jan 25, 2020. Updated with recent data June 14, 2021.)

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The 6 least competitive medical specialties are:

Family Medicine
Pediatrics
Physical Medicine and Rehabilitation
Psychiatry
Anesthesiology
Emergency Medicine
Getting into any residency program, regardless of the specialty, is no easy task. It requires completing 4 years of medical school, taking USMLE Step 1, writing a personal statement, doing interviews, and several other steps that are not to be taken lightly. That being said, your life becomes much easier if you apply to a less competitive specialty.

If your specialty is not considered as competitive, this doesn’t make you a good or bad doctor. It’s just the facts, without any judgment, so please no butt-hurt comments.

We’ll be using the same methods from our previous video on the top 5 most competitive specialties. We’re taking into account the match rate, average Step 1 score, Step 2CK score, number of publications, percentage of matriculants who are AOA, and the percentage from a top 40 NIH funded medical school.

1 | Family Medicine (15 points)
Family medicine is by far the least competitive specialty to match into, scoring only 15 points in our dataset, with the runner up at 27 points.

Family medicine is the specialty devoted to the comprehensive medical treatment of patients across all ages. Think of them as the first-line defense when it comes to maintaining health. Family med doctors are central to routine checkups, preventive care, health-risk assessments, immunization, screening tests, and acting as the coordination hub to manage the patient’s big picture treatment across several specialties. While less common, some family medicine doctors also deliver babies and provide prenatal care to pregnant women, which is now more commonly performed by OB-GYN doctors.

Family medicine is a foundational specialty to medicine, with nearly one out of every four office visits being made to family med physicians — that’s 208 million office visits each year, with the next closest specialty at 83 million visits. They’re also the ones doing most of the heavy lifting in treating America’s underserved and rural populations.

After completing medical school, you must complete either a 3 or 4-year family medicine residency. If you’d like to specialize, there are multiple fellowship options to choose from, including geriatric medicine, sports medicine, sleep medicine, hospital medicine, and hospice and palliative care.

In terms of lifestyle, family physicians have predictable hours without unexpected calls in the middle of the night. In terms of compensation, however, they’re toward the bottom, making on average $231,000 per year.

Learn more about what it’s like to specialize in family medicine in our video series: So You Want to Be an OB/GYN.

2 | Pediatrics (27 points)
Placing second is pediatrics, the branch of medicine involving the medical care of infants, children, and adolescents. Think of it as the equivalent of internal medicine, but for patients who aren’t adults. Just like internal medicine, peds is a 3-year residency. And just like internal medicine, there are dozens of subspecialties to choose from through fellowship training, like pediatric cardiology, emergency medicine, nephrology, oncology, infectious disease, and many more.

Working with kids is a mixed bag. On one hand, it’s incredibly gratifying to help children in need. On the other hand, it can be tremendously disheartening to care for a child with cancer or another terminal illness. As a pediatrician, you’ll essentially have two patients — the child and their parents, and you’ll quickly become well versed in handling upset or crying babies as well as highly neurotic parents. As a college student and first-year medical student, I was aiming for pediatric gastroenterology, but after working in the department for a few months, I realized working with kids and their parents every day wasn’t a challenge I was excited to take for the rest of my life.

In terms of lifestyle, pediatrics is so broad and varied that you can be anywhere on the spectrum. On average, however, pediatricians are one of the lowest compensated physicians, making on average $225,000 per year.

We dug deeper into what it’s like to be a pediatrician in our video series: So You Want to Be a Pediatrician.

3 | Physical Medicine & Rehabilitation (28 points)
Physical medicine and rehabilitation, or PM&R for short, and also called physiatry, is the specialty focused on restoring functional ability, reducing pain, and enhancing the quality of life for individuals with physical impairments or disabilities.

PM&R doctors use non-surgical methods to treat conditions such as spinal cord injury, traumatic brain injury, stroke, limb amputation, chronic pain, and a variety of sports injuries and musculoskeletal disorders. When I visited the PM&R clinic as a medical student, we saw several cerebral palsy patients as well. While it may be easier to get into PM&R residency, I would consider the specialty anything but easy. Dealing with this sort of patient population day after day can be highly taxing and discouraging without high degrees of patience, compassion, and optimism.

Treatment modalities, of course, include medication, but also physical modalities such as heat, cold, ultrasound, or electrical stimulation. PM&R doctors also make use of adaptive equipment and devices such as braces, artificial limbs, and wheelchairs, and also perform spine and joint injections, often under fluoroscopic or ultrasonic guidance.

Including intern year, PM&R residency is a total of 4 years. If you’d like to subspecialize further, you can complete a fellowship in musculoskeletal & spine, stroke, multiple sclerosis, neurorehabilitation, electrodiagnostic medicine, cancer rehabilitation, or occupational and environmental medicine.

As for lifestyle, PM&R doctors have predictable hours, no crazy calls, and make mid-range physician salaries at an average of $306,000 per year.

More on physical medicine and rehabilitation in our video So You Want to Be a Physiatrist (PM&R).

4 | Psychiatry (35 points)
Psychiatry, not to be confused with psychology, is the practice of medicine devoted to the treatment and management of mental disorders. It wasn’t until I started doing YouTube that I learned of the negative stigma some people have against psychiatrists, which puzzled me. It turns out this misplaced distaste of the profession arises from questionable and unethical practices regarding the use of lobotomy and electroconvulsive therapy in the mid 20th century. Since the 1970’s, however, psychiatry as a profession has tightened up ethical codes and addressed the misconducts of the past.

Psychiatry is a favorite rotation amongst medical students because it’s… well, chill. You won’t be working before 9 or after 5, and in fact, you’ll probably have many days shorter than that. On the other hand, while the subject material of mental illness is endlessly fascinating, the practice of psychiatry leaves many medical students feeling lethargic. You’ll be speaking to one patient sometimes for close to an hour, you’ll need to be incredibly patient, and sometimes it may feel like you’re just talking to them and not doing enough.

Psychiatry residency is 4 years, after which you can subspecialize in addiction, child and adolescent, forensic, geriatric, psychosomatic, and more.

In terms of lifestyle, you’ll be working at a slower pace and usually won’t have to deal with calls at odd hours in the night. In terms of salary, the average psychiatrist is in the bottom quartile in terms of physician compensation at $260,000 per year.

Best Medical Specialties For Female Doctors

Female-dominated specialties

On the whole, when adding in specialties, subspecialties and combined specialties, women account for 45.6% of active GME trainees in the U.S. That number is a slight uptick from data collected in the prior year’s census.

Specialty choice trends among women remained relative consistent with prior-year data. Among specialties with at least 50 active residents, women make up a larger percentage of residents in:

  • Obstetrics and gynecology—83.4%.
  • Allergy and immunology—73.5%.
  • Pediatrics—72.1%.
  • Medical genetics and genomics—66.7%.
  • Hospice and palliative medicine—66.3%.
  • Dermatology—60.8%.

Among the top specialty choices for female residents, only dermatology, with an annual average compensation of $419,000 ranks in the top 10 highest-paying specialties, according to an online survey of 2019 physician compensation conducted by Medscape.

Male-dominated specialties

Male physicians accounted for the majority of physicians in this year’s census. The list of specialties in which men make up the most significant portion of the working resident physicians was heavily populated by surgical specialties. Popular specialties in which men made up a significant portion of the resident workforce include:

  • Orthopedic surgery—84.6%.
  • Neurological surgery—82.5%.
  • Interventional radiology (integrated)—80.8%.
  • Thoracic surgery—78.2%.
  • Pain medicine—75.3%.
  • Radiology—73.2%.

Specialties with most gender balance

Four specialties featured a near equal mix of men and women among the population of current medical residents: sleep medicine, preventive medicine, pathology (anatomic and clinical), and psychiatry.

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