The 10 Most Competitive Medical Specialties Today

Choosing a medical specialty is one of the most important decisions in your career. Some students know early on which field they’re drawn to, while others make the decision during medical school. Whatever your path, it’s essential to understand the level of competition in your desired specialty—especially if you're applying to a U.S.-based residency.

Below, we highlight the most competitive medical specialties, ranked based on USMLE scores, number of applicants, available residency positions, and overall match difficulty.

These specialties are tough—but incredibly rewarding for those who match into them.

What Makes a Medical Specialty Competitive?

To match into these programs, students need:

• High USMLE Step 1 and Step 2 CK scores
• A strong academic record
• Clinical and research experience
• Outstanding letters of recommendation

If you’re still exploring your options or need help strengthening your application, Go Elective offers medical and pre-med internships in Kenya and Tanzania to boost your real-world clinical experience and global healthcare exposure. Learn more about our programs.

#1 Orthopedic Surgery

• Average USMLE Step 1 Score: 248
• Residency Length: 5 years + potential fellowship
• Recent Applicants: 239
• Residency Spots (Recent Match): 31
• Average Salary: $500K+

Orthopedic surgeons treat musculoskeletal conditions such as fractures, spinal disorders, and degenerative diseases. With one of the lowest number of spots and high competition, it tops our list.

#2 Neurological Surgery

• Average USMLE Step 1 Score: 245.5
• Residency Length: 7+ years
• Recent Applicants: 397
• Residency Spots: 232
• Average Salary: $600K+

Neurosurgeons handle complex procedures involving the brain, spinal cord, and nervous system. It requires immense precision, years of training, and attracts the most determined candidates. 

#3 Plastic Surgery

• Average USMLE Step 1 Score: 248.5
• Residency Length: 6 years
• Recent Applicants: 291
• Residency Spots: 180
• Average Salary: $400K+

This specialty includes both cosmetic and reconstructive surgery, making it intellectually stimulating and financially lucrative.

#4 Otolaryngology (ENT)

• Average USMLE Step 1 Score: 250
• Residency Length: 5 years
• Recent Applicants: 505
• Residency Spots: 350
• Average Salary: $375K

ENT specialists treat head and neck conditions, including sinus surgery, hearing loss, and throat cancer. This field combines medicine and surgery in fascinating ways.

#5 Dermatology

• Average USMLE Step 1 Score: 251
• Residency Length: 4 years
• Recent Applicants: 239
• Residency Spots: 31
• Average Salary: $400K+

Dermatology is known for its high lifestyle satisfaction and high salaries, making it one of the most sought-after fields.

#6 Radiation Oncology

• Average USMLE Step 1 Score: 244.5
• Residency Length: 4 years
• Recent Applicants: 169
• Residency Spots: 192
• Average Salary: $418K

Radiation oncologists play a key role in cancer treatment. Although fewer applicants apply, strong scores and research are still crucial.

#7 Urology

• Average USMLE Step 1 Score: Not available (typically high)
• Residency Length: 5–6 years
• Recent Applicants: 484
• Residency Spots: 354
• Average Salary: $380K

Urology encompasses surgical and medical management of male and female urinary tract disorders. Sub-specialties increase competitiveness.

#8 Ophthalmology

• Average USMLE Step 1 Score: 244
• Residency Length: 5 years
• Recent Applicants: 635
• Residency Spots: 496
• Average Salary: $343K

From cataracts to retinal surgeries, ophthalmology requires fine motor skills and precision. A rapidly advancing field with significant demand.

#9 Diagnostic Radiology

• Average USMLE Step 1 Score: 245
• Residency Length: 4 years
• Recent Applicants: 1,232
• Residency Spots: 1,146
• Average Salary: $400K+

Radiologists interpret imaging to diagnose and guide treatment. Though many spots exist, demand for these roles keeps competition fierce.

#10 General Surgery

• Average USMLE Step 1 Score: 238.5
• Residency Length: 5+ years
• Recent Applicants: 2,183
• Residency Spots: 1,536
• Average Salary: $360K

General surgeons perform a variety of procedures, often in emergency settings. It’s a broad specialty and a stepping stone to surgical sub-specialties.

 
How to Stand Out for Competitive Specialties

• Score high on Step 1 and Step 2 CK
• Gain relevant research and leadership experience
• Publish in peer-reviewed journals
• Secure strong letters of recommendation
• Get hands-on clinical experience, including shadowing and international internships

Go Elective offers exceptional pre-med, pre-health, and medical internships abroad where you can shadow physicians and work in resource-limited healthcare systems. These experiences demonstrate adaptability and global health awareness—qualities top residency programs value.

Explore internship opportunities in Kenya and Tanzania.

Final Thoughts: Choosing Your Specialty Wisely

Matching into a competitive specialty isn’t easy, but it’s achievable with planning, hard work, and guidance. If you’re unsure which field suits you best, consider what excites you during rotations, your long-term lifestyle goals, and the types of patient interactions you enjoy.

Need guidance? Go Elective not only offers global internships but also supports pre-med and med students through mentorship, career exploration, and application support.

Article Details

Categories

Recent Articles , Pre-health, Medical Electives,

Author: Go-Elective Abroad

Date Published: May 10, 2025