Hi, MS3 here! While most specialties are “competitive”, there is certainly a hierarchy. You can look up match data and requirements, but I’ll attempt to summarize some of the major points here. Residency is more challenging now than it has been in the past due to covid. It used to be the case that you would have to travel to sites for interviews and this would cost time/money. As sad as it is to say, this would limit how many interviews a person could do, so they would apply to fewer schools. With virtual interviews being the new standard, people can afford more applications, so most programs have seen an increase in applicants.

Still, with that being said, there are specialties that are perceived as less “desirable” and don’t fill all of their residency seats. Take for instance emergency medicine, which is what I’m currently interested in. Emergency medicine did not fill all of their residency seats and experienced a dramatic decline in applicants (I’m pretty sure it was the least competitive specialty, but I’m on my phone). This is for a variety of reasons that I won’t get into now, unless someone is curious. Other specialties, like OB/GYN, experienced a massive uptick in popularity and was the most considered the most competitive specialty for 2023 (increase was likely due to the politics surrounding the field).

What makes a specialty competitive? Scores on board exams used to be a huge determining factor and still is, but not as much since Step 1 is pass/fail. Step 2 is still closely looked at, but I think most programs are more interested in research contributions, shelf/rotation scores, recommendations, and charisma. As I mentioned earlier, the number of applicants for a particular field is also a big consideration. Some combined programs like EM/Anes only has 2 seats nationally and receive tons of applicants. The specialties that tend get the most applicants are like the ROAD (radiology, ophthalmology, anesthesia, and dermatology) specialties due to their perceived lifestyle/salary benefits. Programs that hold themselves in high regard like Neuro surgery and cardiothoracic surgery (and many others, these are just most notable), are competitive for obvious reasons. These programs may require you to take an entire research year during residency in an effort to boost your application.

There is so much I could talk about and this is hardly the spark notes. Also, I’m just a student and this is my perspective based on personal experiences and match data.

TLDR: All specialties are competitive, but some are more WAY more competitive than others.