This question was originally posted on Quora.com and was answered by Lacy Windham, studied at University of Tennessee Health Science Center Competitive medical specialties have limited training opportunities and large demand from medical students. Which one is most competitive often varies from year to year. It depends on the interests of graduating medical students that year. Programs which remain highly competitive and difficult to match in generally include cardiac surgery, dermatology, general surgery, neurosurgery, orthopedic surgery, ophthalmology, otolaryngology, plastic surgery, urology, radiology and radiation oncology. Moderately competitive programs include anesthesiology, emergency medicine, medicine/pediatrics (combined) and Obstetrics and gynecology. When I started medical school, one of my classmates knew from the beginning that she wanted to be a radiation oncologist. There are only 15 residency slots for a usual 140 applicants. The overwhelming majority of people who attempt to match in that specialty are not able. Most of us worked hard and studied long hours, but she took it to another level. If the rest of us decided to take a few hours off and go see a movie, she stayed home and studied. When the rest of us decided to go win some pub trivia, she stayed at home studying. When we got the results back for our Step 1 exam (the exam that allowed us to move onto our clinical rotations), I was satisfied with my solid score in the high 230s. Her score was 260 something. The closest trailing student was over 10 points behind her. On match day she had a place in a Radiation Oncology residency program. Those are the hardest medical specialties in which to find a training slot. They are not necessarily the most difficult career paths. Some specialties are prestigious because they offer a high quality of life and reimbursement. Yet some of the most competitive specialties also lead to a lifetime of long and difficult working hours. In terms of what the hardest medical specialty actually is, I agree with many of the other responses to this question. It’s the one you are not suited for. It’s the one you don’t enjoy. It’s the one you aren’t passionate about. Source
