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On this channel, we've discussed the top five most competitive specialties as well as the top six least competitive specialties.

But in this video, we're going to do a deep dive into the basis for those lists and discuss the factors that dictate what makes a speciality competitive.

Let's start by defining what we mean by a specialties competitiveness.

The first thing that typically comes to mind is it's Maitreya every couple of years, the national residency matching program or an RMP post data on the most recent residency application cycle, they record a variety of different statistics, including the number of medical students that match into each specialty versus the total number of applicants to that specialty.

This is referred to as that specialties match rate for most people.

This is the holy grail of determining how competitive a specialty is, but it's not all its chalked up to be matron alone is a very poor metric in determining a specialties competitiveness.

Is it helpful?

Yes.

Should we pay attention to it, of course.

But does it tell the full story?

Absolutely not.

And here's why first specialties are self selecting each specialty attracts a certain type of applicant.

The match, which I have explained in a previous video covers the process in depth.

In short, it's in the applicants best interest to only apply to specialties that they have a realistic chance at getting into.

If you're not a competitive applicant to you're not going to apply to something like dermatology or plastic surgery because you won't get in plain and simple.

Now, why does this matter when talking about match rates?

Match rates don't account for this fact that applicants are already pre screened before even applying.

For example, general surgery has a match rate around 84% in 2018.

This was lower than plastic surgeries 85%.

But when you look at the average step scores and other factors in addition to the fact that many plastic surgery applicants use general surgery as a backup in case they don't get into plastics, it becomes clear match rate alone isn't a reliable indicator.

Another shortcoming of match rate that is often overlooked involves international medical graduates or I.

Mgs graduating medical students come from all over the world to finish their medical training in the U.

S.

And there are certain specialties that attract more I.

Mgs than others.

This is important because I am the match into U.

S.

Residencies at a far lower rate than us graduates.

So if a specialty attracts a large number of I.

M.

G.

Applicants, it can make it difficult to compare to a specialty that doesn't to overcome the shortcomings, I gather data from the N.

R.

M.

P.

And organize it into a spreadsheet.

I examined six categories of data, average metric step one score, step two CK score, number of publications, percentage of meticulous that were a.

O.

A.

And percentage of applicants from a top 40 NIH funded school for the full results and link to the spreadsheet.

Check out my videos covering the top five most and top six least competitive specialties.

Link in the description now that we've looked at the competitiveness of a specialty as it relates to applicant metrics.

Let's look at it from a more macroeconomic perspective and explore the concepts of supply and demand supply when referring to a specialties, competitiveness refers to the number of open residency positions available specialties with few residency positions are generally more competitive than specialties with more residency positions.

In essence more residency positions means more chances to get in the supply of residency positions for a given specialty is largely dictated by the societal demand for that specialty specialties like internal medicine have high societal demand.

Internal medicine physicians are the backbone of our hospital systems.

They're often referred to as the quarterbacks of inpatient care.

They manage the patient's overall plan of care while in the hospital and often serve as the bridge between the patient and other consulting specialties.

Internal medicine is also a gateway into multiple fellowships, including cardiology, gastroenterology, Hulman ology, infectious diseases, hematology, oncology, nephrology and more.

Any physician wishing to pursue the specialties will have to go through internal medicine residency first for these reasons.

Our society needs a lot of physicians to go into internal medicine, making the societal demand for internal medicine high according to the double AMC, there is approximately one internal medicine physician for every 2800 people.

If we contrast this with something like plastic surgery, that has less societal demand, there is approximately one plastic surgeon for every 45,000 people.

I'm not saying plastic surgeons are not important is just that objectively.

There are fewer people that require the services of a plastic surgeon compared to an internist.

This is one of the contributing factors to plastic surgery being more competitive than internal medicine.

Additionally, the majority of funding for residency programs comes from the federal government through Medicare and Medicaid.

Graduate medical education payments are made to teaching hospitals and health systems, which then have control over how those funds are allocated.

The financial impact of residency training programs on these teaching hospitals and health systems is complex and not well understood.

However, research has suggested that there are substantial differences in the financial impact of different specialties.

This means that hospitals may have incentives to fund residency positions and specialties that generate their facilities more revenue.

Internal medicine and its related services drive a large portion of a hospital's revenue.

For this reason, there is a financial incentive on the part of the hospital to fund I am residency positions.

This may be another contributing factor to why I am, has the largest number of residency positions.

By far this works in the reverse direction as well.

And that if a particular specialty does not generate the facility a lot of revenue, then there is a disincentive to adding residency positions for that specialty.

In addition to societal demand demand can also refer to the number of medical students that want to go into a particular specialty.

In essence, how desirable is that specialty to a medical student?

The primary factors that influence the desirability of a specialty?

Our compensation and lifestyle.

How much money do you make and how hard do you work to make it?

Many people will tell you that money shouldn't be a factor when becoming a doctor.

Although this is true for most students, when they enter medical school, by the time they graduate, they often place a greater emphasis on the importance of lifestyle.

For this reason.

Specialties that have a good lifestyle and high compensation like dermatology are typically seen as more desirable.

If we refer back to our competitiveness index, this may explain why dermatology is ranked as the number one most competitive specialty.

Additionally, plastic surgery, neurosurgery and orthopedic surgery.

Also ranked in the top four.

And just so happen to be the three highest compensated specialties.

Prestige is another factor that influences the desirability of a specialty, albeit to a lesser degree than compensation and lifestyle.

Some students are attracted to a particular specialty because of the respect and admiration they believe they will receive from others if they go into it.

Surgical specialties in particular are often seen as more prestigious and coincidentally tend to be more competitive compared to non surgical specialties.

Although this is an important factor for some, I would strongly recommend against letting it dictate your choice of specialty prestige is very externally focused.

It takes the emphasis away from what you want and what you enjoy and places it on what other people think going into a specialty that you actually enjoy will be far more important in your long term happiness than the mental exercise of thinking.

Which specialty has the best lifestyle, best compensation or most prestige.

If you find yourself getting discouraged because your dream specialty ranks high on the competitiveness index or has low supply relative to its demand.

Don't fall into the trap.

I've seen many succumb to I've come across dozens of residents and attending physicians who wanted to do a different specialty like orthopedics or dermatology or plastic surgery but ultimately decided they weren't competitive enough for the specialty that they truly desired.

If you think you're not the smartest and that you're doomed.

Stop right there.

Your ability to crush your um cat us Emily and have dozens of research articles is less a function of your intelligence and more, a function of proper preparation, constantly improving and putting in the work, having a stellar medical school or residency application and crushing the interviews is no different.

Even if you don't consider yourself a people person at med School Insiders, our mission is to empower a generation of happier, healthier and more effective future doctors from medical school or residency application.

Help to crushing your cat or us.

Emily, we've got your back and our results speak for themselves.

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See for yourself and learn more at medical Insiders dot com.

Thank you all so much for watching.

If you enjoyed this video, check out the top five most competitive specialties or the top six least competitive specialties.

Much love and I'll see you guys there.

Mhm.

Mhm.