Match Week: What Are the Most ‘Competitive’ Specialties?

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It’s the first day of Match Week, and applicants have just learned whether they’ve matched into a program. But some already may have been more certain about their chances of matching than others, given that competition across medical specialties varies.

While match rates can fluctuate over time, data from the previous residency cycle provide a peek into what to expect during this year’s match. MedPage Today analyzed 2020 match rates to see how specialties stack up against each other.

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Plastic surgery had the lowest match rate in 2020, with 72% of applicants matching into a residency program in the specialty. Otolaryngology, neurological surgery, vascular surgery, and orthopedic surgery also had match rates lower than 80% during that year — marking them as “more competitive” than other fields.

Radiation oncology, however, had the highest match rate, with 99.2% of applicants snagging a residency spot. Other specialties with higher match rates — which are considered “less competitive” — included pediatrics, neurology, internal medicine, and family medicine.

These data come from the NRMP’s Charting Outcomes Report for 2020. The report only includes applicants who matched in their preferred specialty — that is, the specialty they ranked first. Also, the MedPage analysis only includes U.S. MD Seniors.

While the number of applicants who match into their preferred specialty may indicate how competitive that specialty is, experts say that match rates are a blunt measure of competition. One criticism of using match rates to determine competition is that self-selection could influence the results. Because candidates might feel discouraged from applying to a specialty if they did not think they had a shot at matching, the rates could be skewed.

Additionally, there are several factors that can determine how competitive a specialty is — not just the match rate. Credentials of applicants who match in a specialty, such as mean board scores, average number of publications, number of applicants with high honors, and the number with PhDs all contribute to how competitive a specialty is.

Nevertheless, match rates do provide an important piece of information: the proportion of applicants that do — and don’t — secure a training position in their specialty of choice.

Francis Deng, MD, of Massachusetts General Hospital in Boston, said that match rates are a good first pass at understanding specialty competitiveness. But absolute numbers of matched and unmatched applicants in each speciality, he added, provide a better picture into how applicants fare in the match.

Deng, who tweeted his own analysis on match rates by specialty earlier this year, told MedPage Today that it is not usually the smaller, highly competitive specialties that leave the greatest number of applicants without a training position.

“The largest specialties of moderate competitiveness account for the highest number of unmatched students,” Deng said in an interview.

In ob/gyn, for example, which has become increasingly competitive in recent years, 1,200 candidates applied for a slot in 2020. Nearly 200 of those candidates went unmatched. But in plastic surgery, the specialty with the lowest match rate, 229 candidates applied, and around 60 did not match.

“Even though the highly competitive specialties take a lot of mind space, … they are still a relatively small slice of the pie in the house of medicine,” Deng said.

  • Amanda D’Ambrosio is a reporter on MedPage Today‚Äôs enterprise & investigative team. She covers obstetrics-gynecology and other clinical news, and writes features about the U.S. healthcare system. Follow





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