10 most competitive residencies 2020 guide (1)

10 Most Competitive Residencies (2023 Guide)

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Do you want to know the most competitive residencies? As of this moment, you might have already graduated from medical school or you just wanted to grab some great ideas on what to specialize in the future.

In residency, it’s the time when you step on the frontlines and perform your all-time aspired role of becoming a doctor. But, there are a lot of residencies you want to concentrate on depending on your interests.

In this post, I will be listing the most competitive residencies in 2021 to help you decide which to apply for matching. I’ll give you the hospitals that offer the best medical residency programs and tips on how to stand out in your residency application.

Most Competitive Residencies

10 most competitive residencies dermatology

Here are the specialties that are most difficult to match.

1. Dermatology

Total number of matches among MD Seniors: 31

Total percentage filled by MD Seniors: 100%

American dermatologists have an average USMLE Step result of 251 which makes them one of the most competitive residencies to match. Vacant positions are very rare with a salary amounting to $400,989. No doubt why most MDs try to compete for this position.

2. Surgery (Categorical)

Total number of matches among MD Seniors: 1532

Total percentage filled by MD Seniors: 99.7%

Soon-to-be surgeons have USMLE results with an average of 238.5. MD seniors compete for 1.1 open surgeon positions because of a promising salary of $360,933.

3. Orthopedic Surgery

Total number of matches among MD Seniors: 844

Total percentage filled by MD Seniors: 99.4%

One of the most competitive residencies in the USA, aspiring orthopedic surgeons has USMLE scores of 248. They compete for only 0.83 positions in the USA. But if they’re the best of the best, once accepted, they can earn an average of $535,668 every year. This residency training completion takes 5 years.

4. Neurological Surgery

Total number of matches among MD Seniors: 232

Total percentage filled by MD Seniors: 100%

The average USMLE score of neurological surgeons is 245.5. They compete for a 0.93 ratio of vacant neurological positions. Quite rare but once accepted, one can earn annually up to $609,639.

5. Psychiatry 

Total number of matches among MD Seniors: 1838

Total percentage filled by MD Seniors: 98.9%

Perhaps, this is the trendiest residency program today given the increased number of doctors who desired to go into this field. Mental health problems have become emergent worldwide. If you are interested in taking care of people’s mental health, then this would be a rewarding program for you. On top of that, you could earn as much as $260,000 a year. If you want to get matched with Psychiatry, you must have a USMLE score of 220.   

6. Otolaryngology

Total number of matches among MD Seniors: 348

Total percentage filled by MD Seniors: 99.4%

Otolaryngology is the oldest medical specialty in the United States. Yet today, it has been one of the most competitive residencies of all-time. It’s not easy to get in as an aspiring otolaryngologist must have an average USMLE score of 250. Positions are quite rare as they compete for a salary of $369,790 a year.

7. Integrated Plastic Surgery

Total number of matches among MD Seniors: 180

Total percentage filled by MD Seniors: 100%

As opposed to otolaryngology, integrated plastic surgery is one of the youngest in the US medical field. It has attracted the eyes of many doctors due to the opportunity to earn a mid-year salary of $407,709. However, for you to get in, you must at least have an average USMLE test score of around 248.5.

8. Anesthesiology

Total number of matches among MD Seniors: 1369

Total percentage filled by MD Seniors: 99.9%

To have a greater chance to get matched, you must have at least a 220 USMLE score. The higher, the better. An average annual salary of an anesthesiologist is $261,730. It may not be the highest-paid specialty compared to the others I listed, but anesthesiologists are in demand for almost any procedure.

Wondering how long it takes to be an anesthesiologist? Check out my article here. And here are the best online resources for anesthesiology.

9. Integrated Interventional Radiology

Total number of matches among MD Seniors: 37

Total percentage filled by MD Seniors: 97.4%

The average salary of an interventional radiologist could be as high as $600,000 a year. They are one of the highest-paid doctors in the USA. If you plan to be accepted, you must have a USMLE score of at least 246.

10. Radiation Oncology 

Total number of matches among MD Seniors: 11

Total percentage filled by MD Seniors: 78.6%

Closely related to cancer treatment, radiation oncology has been in demand recently. An average USMLE score of 244.5 will help you get a residency in Radiation Oncology. Many doctors eye for this specialization as it could get them to earn as much as $418,288 every year.

Most Competitive Hospitals For Residency

most competitive hospitals for residency

Source: McGaw Medical Center

According to thousands of doctors, here are the 10 most competitive hospitals for residency. They are compared based on hospital prestige, competition, and residency’s mission.

1. McGaw Medical Center of Northwestern University, Chicago

McGraw Medical Center has tons of clinical and research opportunities for students. It offers diverse clinical settings, patient conditions, and management opportunities.

After three years of training, residents are guaranteed with excellent skills in patient management, research, and leadership roles. It has 24 medical residency programs in which internal medicine is the most in-demand. 

2. University of Pennsylvania, Philadelphia

The University of Pennsylvania’s medical residency program’s curriculum is geared to educate basic clinical knowledge in internal medicine. It aims to develop clinical, research, and teaching skills.

They offer a variety of medical residency programs and electives to match diverse medical career goals.

3. Washington University/Barnes-Jewish Hospital, St. Louis, Missouri

Barnes-Jewish Hospital is a teaching hospital that offers the most competitive residencies in the USA. Physicians mentor residents through a 4-year program. Their curriculum has been continuously innovated to produce excellent doctors.

Their most esteemed medical residency program in Emergency Residency has board certification in emergency medicine.

4. New York Presbyterian Hospital (Columbia Campus), New York

The New York Presbyterian Hospital offers one of the best Internal Medicine Residency programs in the country. They excel both in research and clinical management.

Esteemed physicians mentor the residents and harness unmeasurable knowledge and skills to their trainees. They aim to produce well-rounded doctors who could serve as physicians, community leaders, and researchers.

The training program takes three years and it includes inpatient and outpatient training experiences, career development, teaching, and research opportunities.

5. Duke University Hospital, Durham, N.C.

Duke’s Department of Medicine has been regarded as one of the best because of the autonomy and camaraderie between health professionals. They aim to produce diverse groups of faculty and trainees who could provide the best management possible for the patients. 

Career growth and autonomy is promoted by allowing residents to develop their learning plans. The program lasts for 3 years concentrating on the fundamentals of patient care. 

6. University of California, San Francisco

This hospital offers a unique residency program that prioritizes the caring for the underserved. They develop doctors who are compassionate and committed to serving the poor and vulnerable through various effective and accessible primary care approaches.

They produce physicians who could lead in the academe, community, and clinical setting. Autonomy is promoted by encouraging residents to customize their education and focus on their respective specialties of interest.

7. Brigham and Women’s Hospital, Boston

Brigham and Women’s Hospital provides intensive training for residents to prepare them in their more advanced medical careers. The hospital provides individualized career mentoring and clinical training. Their goal is to hone physicians’ skills in terms of patient care, research, and organizational leadership. 

8. Mayo Clinic, Rochester, Minnesotta

Currently lands as one of the best hospitals in the US, the Mayo Clinic has produced several of the finest doctors in the country. In a course of 3 years, they train their residents in a supportive and collaborative learning environment.

Their curriculum emphasizes clinical care, longitudinal care, and tertiary care. Catering over 140,000 patients a year, you’ll have tons of opportunities to develop your skills as a doctor.

9. Massachusetts General Hospital, Boston

Massachusetts General Hospital offers an intensive internal medicine training. They expose residents in inpatient and ambulatory settings. They also provide research opportunities to those who want to become future physician-scientists.

Their curriculum gives high regard to direct patient care. Residents are supervised until they could finally manage patients on their own. They complement patient care with lectures and interactive discussions.

10. Johns Hopkins University, Baltimore

Johns Hopkins is one of the best hospitals that offer outstanding residency training programs. Its high board passing rates make it one of the most competitive. 

 They have a variety of specialty areas that focus on innovation and excellence. They aim to produce well-rounded doctors that specialize in evidenced-based patient care and public health servants. 

If you are curious about how it is to become a new doctor in residency, you may check out my post here

How Do You Get Into The Most Competitive Residencies?

how to get into the most competitive residencies

Now that you have an idea of what residency program that suits your preference, the next challenge is how would you be able to stand out to grab the golden opportunity to get accepted on your first choice. 

First of all, it’s important to know what residency programs you are looking for. You would then pattern other strategies according to their standards. One of which is a high USMLE score. The higher your USMLE score is, the greater chance you’ll surely be accepted to the top medical residency programs. Check this blog post on how to boost your USMLE scores.

Also, they assess letters of recommendation and personal statements. If it came from a prominent professor or clinical expert, then you might just add significant points to your slot.  You may refer to this article as guide on writing a personal statement for residency applications.

Here are some tips you could follow to get accepted into the most competitive residencies.

1. Applying For Away Rotation Is An Advantage

By having an away rotation, you can impress a faculty by seeing you in duty. This is beneficial as you could have a chance to convince the attending physician and house staff of your abilities, knowledge, and work ethics which would make you a perfect match for the program. 

Pro-tip: Try to meet the program director the second time when you’re about to finish your rotation. It would serve as a courtesy and reminder of your burning interest in the program.

Keep in mind that not every specialty needs an away rotation. Ask your program advisor if they recommend that you do one!

2. Excel in Research

Medicine is leaning towards the research trend. Most hospitals are looking for individuals who don’t only excel clinically but also in the research setting. 

Try to have at least a peer-reviewed presentation or publication. This is a good impression of how diverse you could be. Program Directors consider research as one of the main factors in selecting individuals for interviews. 

Check out more bonus tips on doing research in medical school here. 

Also here’s a video where I explain the benefits of research in med school.


3. Lead In Student Organizations

Program Directors seek to produce doctors who could be leaders in various settings. When they know that you are a leader, it gives the impression that you have great initiative and uphold a sense of responsibility and commitment. 

Remember this is an opportunity to show your leadership qualities. Not a resume stuffer.

If it doesn’t intrigue, speak to your future goals, and unrelated to your field don’t do it.

A few great examples would be working as a lead coordinator for a free dermatology clinic if you were interested in derm. Make sure any extracurricular activities are related to your goals or at least enjoyable.

4. Pursue a Dual Degree

Healthcare is multidimensional. If you are interested in the broad aspects of it, you may try enrolling in a dual degree in business administration or public health. 

By no means is this necessary but having a master’s in public health or Ph.D. may make you more attractive for a program that is focused on population-level care or research, respectively.

6. Bonus: Aim For A Competitive Specialty Early Even If You’re Unsure

What if you don’t know the field you want to go into?

Maybe it’s competitive or maybe you pick something less so?

What approach should you take?

My recommendation would be to act like you’re going to ultimately choose the most competitive specialty. 


In a nutshell, you give yourself the motivation to build your CV (research, shadowing, extracurriculars, etc.) and have the option to continue to pursue the field.

But on the flip side, waiting too late to decide to “get it together” may be too late for you to be truly competitive.

What Are The Least Competitive Residencies?

what are the least comptetitive specialties

If there are most competitive residencies, there are also those that are less competitive in which it’s easier to get into, such as the following:

1. Family Medicine 

Total number of matches among MD Seniors: 4313

Total percentage filled by MD Seniors: 92.5%

Mean USMLE Step 1 Score To Match: 220

Mean USMLE Step 2 Score To Match: 237

2. Internal Medicine

Total number of matches among MD Seniors: 8324

Total percentage filled by MD Seniors: 95.7%

Mean USMLE Step 1 Score To Match: 233

Mean USMLE Step 2 Score To Match: 246

3. Pathology

Total number of matches among MD Seniors: 587

Total percentage filled by MD Seniors: 97.3%

Mean USMLE Step 1 Score To Match: 233

Mean USMLE Step 2 Score To Match: 242

4. Pediatrics

Total number of matches among MD Seniors: 2812

Total percentage filled by MD Seniors: 98.2%

Mean USMLE Step 1 Score To Match: 227

Mean USMLE Step 2 Score To Match: 243

5. Neurology

Total number of matches among MD Seniors: 665

Total percentage filled by MD Seniors: 97.5%

Mean USMLE Step 1 Score To Match: 231

Mean USMLE Step 2 Score To Match: 242

What Are The Shortest Residencies?

Med school is an endless journey of learning and training. Your journey doesn’t stop when you graduate from med school. 

If you’re wondering how long it takes to become a doctor, you might want to check out my article here.

Perhaps by any chance, you wanted a shortcut, you’ve been wondering if any residency programs provide the shortest training. Here is a list of residency programs that offer 3 years of training:

  • Anesthesiology
  • Dermatology
  • Emergency Medicine
  • Internal Medicine
  • Neurology
  • Ophthalmology
  • Pediatrics
  • Physical Medicine

If you want to know how long residency is for your chosen specialty, check out my article here!


When you graduate from an accredited med school, your MD journey doesn’t stop there. Instead, you’ll be entering a new one such as a medical residency program.

Pick the one that suits your interest. You will be spending another at least 3 years of your life for training on your specialty of choice.

Decide smart and make your residency application standout. In the end, all of your hard work will be worth it. 

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If you have any questions make sure to drop them in the comments below!

Until next time my friend…

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