Least Competitive Residencies

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Here we’ll take a look at some of the least competitive residencies – those that are traditionally easier to get matched in – either due to a lower number of applicants, a higher number of spots, or simply a bit of both.

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Family Medicine

Family Medicine is considered the least competitive medical speciality. The average USMLE score for a medical student matching into this residency program is low at 221, and more than 96% of applicants will match into a program. This program is realistic for those graduating from foreign medical schools, and many within it will overlook failed classes or multiple attempts to pass board exams. Family medicine involves the general care of a patient from newborn through to geriatrics, and is therefore a true representation of modern Medicine – not a second-choice speciality or something to be chosen because it is easier, but an honest, generalist approach to Medicine. Training takes between 3 to 4 years and will include training in newborn care, training in obstetrics and gynaecology including attending deliveries and providing prenatal care, and inpatient and outpatient adult and paediatric medicine. Family medics no longer staff emergency rooms however, as this responsibility is now the role of those following Emergency Medicine training. Some family physicians will even undertake surgeries in rural areas. Remember that the area in which you work will have a huge impact on the type of work you do – rural areas might rely on their family medics to undertake a huge variety of different workloads, whilst in an affluent urban area you might find yourself specialising in outpatient care and even a particular type of patient.

Physical Medicine & Rehab

This program is not well-known, and requires relatively low scores – average USMLE scores for applicants accepted are in the mid 220s. You can easily match onto a good program with average grades and without having been published – however, you will need good recommendations and will need to perform well at interview. Expect life in this branch of Medicine to cover debilitating conditions like stroke, amputation, spinal cord injury, chronic pain, sports injuries, traumatic brain injuries, and other musculoskeletal disorders. Work can include both adult and paediatric patients, and the pace of treatment – and recovery – is slow. This can prove frustrating, so it requires patient, calm doctors. Expect a great lifestyle with very little in the way of on-call hours and a strong salary of around $300,000 per year.

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Despite being one of the best known specialties, anaesthesiology is relatively un-competitive. Average grades will allow you to match into a program here, and work is shift-based. Salary prospects are great with fully qualified doctors earning around $390,000 per annum. Training takes four years, and hours match those of surgeons, with the two specialties working together. This specialty sees very little patient contact, with a brief conversation pre-op or post-op, but generally work happening alongside fellow doctors and healthcare professionals, rather than ‘with’ patients. You can specialise further and focus on pain management, paediatric anesthesiology, or critical care medicine. Remember that anaesthesiologists are expected to manage difficult airways and intubate; meaning that they are often called upon in critical situations.


Psychiatry is, and always has been, somewhat removed from the rest of Medicine. Psychiatrists often consider themselves as treading something of a line between philosopher and medic, and this can often be seen in those that go on to apply to residency in the field and become psychiatrists themselves. However, disorders of the mind are both good business and becoming more and more part of the daily conversation – mental ill-health is very much a focus of funding today, and this has led to psychiatrists being in higher demand, and in turn demanding higher salaries. Patient visits can be much slower than in other specialties, there’s little in the way of on-call work, and overheads are lower if you wish to operate your own practice. However, on the flipside you might well find either that you lose touch with the more direct, body-oriented fields of Medicine, or that newer treatment modalities have reduced the field to one highly reliant on set prescription algorithms rather than on the complex diagnostic and curative work done in the past – be that for better or worse.

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