15 Most Competitive Residency Programs in US

Published on October 3, 2023 at 4:58 pm by Khadija Shafaat Khan in Industries, Lists, News

In this article, we will discuss the 15 most competitive residency programs in the United States. You can skip our detailed analysis and directly proceed to the 5 Most Competitive Residency Programs in the US.

A multitude of medical school graduates compete for a limited number of coveted spots each year, within the prestigious residency programs of the United States. The competition is nothing short of intense, evidenced by the exponential surge in applications, the elevated level of difficulty, and the strikingly low acceptance rates.

According to data released by the National Residency Matching Program (NRMP) on June 1st 2022, there exist certain residency programs that stand out due to their stringent training regimens and stellar reputation. These programs have garnered a notorious reputation for their complexity when it comes to gaining admission.

For fresh medical school graduates, these residency programs hold the promise of providing invaluable firsthand clinical experience, paving the way for a promising and luminous future in their respective medical specialties. Those fortunate enough to secure a position within these programs invariably represent the pinnacle of the medical industry, possessing exceptional qualities of resilience, unwavering dedication, and advanced clinical expertise.

The Growth and Impact of Residency Programs in the United States

Stats from NRMP released on June 1, 2022, show that the Main Residency Match in 2022 witnessed a total of 47,675 registrants, which was 1,025 fewer than the preceding year, marking the first decline in registrant numbers since 2003. Among these participants, there were 42,549 active applicants.

According to a Accreditation Council for Graduate Medical Education (ACGME) release, published on October 10, 2022, the academic year 2021-2022 witnessed a total of 12,740 accredited programs. Among these, 5,579 were categorized as specialty programs, while 7,161 fell under the subspecialty category. Moreover, 384 programs obtained accreditation status during this academic year. On the other hand, 42 programs either closed or voluntarily withdrew their accreditation, with 14 of them experiencing actions such as Accreditation Withdrawn or Administrative Withdrawal.

In terms of residents and fellows, there were 153,843 individuals actively enrolled in the 12,740 programs. This represented an increase of 4,643 compared to the previous year. Among these 153,843 active residents and fellows in ACGME-accredited programs during the Academic Year 2021-2022, the majority, accounting for 59.6%, hailed from Liaison Committee on Medical Education-accredited medical schools in the United States. International medical school graduates constituted 22.9% of the total, while 17.4% were graduates of osteopathic medical schools.

Competitive residency programs in the US also offer unbeatable opportunities for networking and career development. Due to the extensive range of collaborations they entail, trainees have the advantage of forging professional relationships with mentors, peers, and leading experts in research and practice.

An additional key element driving competition is the ever-growing demand for qualified medical professionals in the United States. As the population continues to increase and age, there is an insatiable need for more physicians, resulting in an amplified supply-demand disparity.

A report by Association of American Medical Colleges (AAMC), published on June 11, 2021, predicted a physician shortage in the United States, ranging from 37,800 to 124,000 by 2034. Such projections amplify the ambition of medical students, as they strive to secure coveted spots in competitive residency programs, highlighting the growing importance of securing a position on the path to becoming a physician.

Physicians can work with some of the top healthcare facilities and services providers including HCA Healthcare (NYSE:HCA), Pediatrix Medical Group (NYSE:MD), and Amedisys (NASDAQ:AMED). Let’s discuss some business updates regarding these organizations.

On August 3, Pediatrix Medical Group (NYSE:MD) reported earnings for the fiscal second quarter of 2023. The company reported earnings per share of $0.39 and generated a revenue of $500.58 million for the quarter, up 2.99% year over year and ahead of Wall Street estimates by $4.73 million.

On September 27, Boston Globe reported that HCA Healthcare (NYSE:HCA) entered a preliminary phase for a possible union with the Catholic Medical Center (CMC) through an exploratory non-binding letter of intent. This action will be followed by further due diligence, negotiations of the final terms, and procuring the required consents. The merger will further the cause of both HCA Healthcare (NYSE:HCA) and CMC in the region.

As reported by Reuters on June 5, UnitedHealth Group Inc. (NYSE:UNH) has made an offer to buy Amedisys (NASDAQ:AMED). UnitedHealth Group Inc. (NYSE:UNH), through its Optum unit, offered a $3.26 billion all-cash bid to acquire home health and hospice care firm Amedisys (NASDAQ:AMED), placing itself in direct competition with Option Care Health, Inc. (NASDAQ:OPCH), which had previously agreed to buy Amedisys (NASDAQ:AMED) for $97.38 per share in an all-stock transaction. This move comes amid a surge in interest for the home health sector since the pandemic, as patients and caregivers increasingly prefer at-home medical services, prioritizing safety.

Students who pass through competitive residency programs can eventually work in the best hospitals in the United States. For greater insights regarding the same, view our article on the 25 Best Hospitals in the U.S.

Understanding PGY-1 and PGY-2 Positions

Residency programs in the United States typically follow a “PGY” system or “Post-Graduate Year.” These numbers, PGY-1, PGY-2, and so forth, indicate the progression of a resident’s training within their chosen medical specialty.

The PGY-1 year, also known as the “internship” or “first-year residency,” is the first year of a doctor’s specialized training after graduating from medical school. During that year, residents receive broad clinical experience in various medical disciplines, including internal medicine, pediatrics, general surgery, emergency medicine, and others pertinent to their chosen specialty.

PGY-1 residents, under the supervision of higher-level residents and attending physicians, begin to take on clinical responsibilities. They examine patients, make diagnoses, develop and execute treatment plans, perform basic medical procedures, and engage in direct patient care.

PGY-2, or the “second-year residency,” takes the foundational clinical skills gained during the PGY-1 year and advances them further. The PGY-2 year often involves increased clinical responsibility, more advanced procedures, and in-depth exploration of the resident’s chosen specialty.

Some programs have their first official year labeled as “PGY-2”, which is common in specialties that require a preliminary clinical year in another field, such as internal medicine. Physicians at this stage are termed PGY-2 residents, regardless of whether it is their second official year of residency. For example, in radiation oncology and dermatology, the official residency program starts at the PGY-2 level.

Our list of the most competitive residency programs in the US will discuss PGY-1 and PGY-2 openings across residency programs in the United States.

15 Most Competitive Residency Programs in US

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Methodology

To identify the most competitive residency programs in the United States, we utilized data from the National Residency Matching Program and their corresponding list of Average USMLE Step 2 CK scores accepted by the different programs.

We conducted an additional assessment to check the number of applicants for the program and the number of corresponding PGY-1 and PGY-2 positions. Some residencies offer both PGY-1 and PGY-2 positions for a specific Match year, while others just offer either PGY-1 or PGY-2 positions. The data, when connected with the most recent average USMLE Step 2 CK scores released in July 2022, helped us compile the list in ascending order. The higher the average USMLE Step 2 CK Score for a residency program, the more difficult it becomes for aspiring doctors to get into.

Having covered these particulars, let us now proceed to rank the most competitive residency programs in the United States.

Note: These stats are for 2022, and while competitiveness remains the same, average scores can vary from year to year.

15 Most Competitive Residency Programs in the United States

15. Family Medicine

Number of PGY-1 positions: 5,088

Number of applicants: 6,927

Average USMLE Step 2 CK score: 241

Family medicine residents gain experience in a wide range of medical disciplines, from pediatrics to geriatrics. Due to its broad scope, this residency program offers excellent applicability in both urban and rural settings, where primary care physicians are in high demand. Graduates from family medicine residency programs have a high success rate in obtaining positions in hospitals, clinics, and private practices.

Some of the top companies active in the health care facilities market include HCA Healthcare (NYSE:HCA), Pediatrix Medical Group (NYSE:MD), and Amedisys (NASDAQ:AMED).

14. Psychiatry

Number of PGY-1 positions: 2,164

Number of applicants: 3,039

Average USMLE Step 2 CK score: 242

Psychiatry residency programs offer specialized training in diagnosing and treating mental health illnesses in patients of all ages. Students in these programs gain hands-on experience with the latest methodologies and technologies used in the field, including various psychotherapies and pharmacological interventions. A psychiatry residency program can lead to a wide range of exciting and rewarding career opportunities in psychology and medicine.

13. Pediatrics

Number of PGY-1 positions: 2,986

Number of applicants: 3,724

Average USMLE Step 2 CK score: 245

Pediatrics residency programs focus on providing comprehensive medical care for infants, children, and adolescents, encompassing preventive care, diagnosing and treating illnesses, and educating families on child health and development. Pediatric residency graduates are equipped with the skills and knowledge necessary to care for young patients.

12. Pathology

Number of PGY-1 positions: 613

Number of applicants: 1023

Average USMLE Step 2 CK score: 245

The Pathology residency program has an average score of 245, and 1,023 applicants vie for 613 PGY-1 spots. This program offers in-depth training in diagnosing diseases and understanding pathological processes through laboratory analyses, such as tissue and cell examination.

11. Emergency Medicine

Number of PGY-1 positions: 3,010

Number of applicants: 2,765

Average USMLE Step 2 CK score: 247

Emergency Medicine provides rigorous training in a wide range of scenarios encountered in the emergency department. Due to the ever-present need for emergency medicine practitioners, the applicability of this residency program is immense and graduates find opportunities in various healthcare settings. The program focuses on acute care, equipping residents with the skills to diagnose, stabilize, and manage patients with life-threatening emergencies and time-sensitive illnesses.

10. Radiation Oncology

Number of PGY-1 positions: 10

Number of PGY-2 positions: 181

Number of applicants: 108

Average USMLE Step 2 CK score: 249

Radiation Oncology, with an average score of 249, is highly competitive due to its limited positions (181 total) for 108 applicants, and ranks 10th on our list of most competitive residency programs in the US. This residency program trains physicians to deliver targeted radiation therapy to treat malignant and benign conditions, including cancer.

9. Internal Medicine – Pediatrics

Number of PGY-1 positions: 392

Number of applicants: 571

Average USMLE Step 2 CK score: 250

Internal Medicine focuses on the comprehensive care of adult patients. With a strong emphasis on clinical reasoning and evidence-based practice, internal medicine residents develop the skills necessary to diagnose and manage a wide array of medical conditions. Applicability of this residency program is wide-ranging, allowing graduates to pursue various career paths, including primary care, hospital medicine, or subspecialties.

8. Vascular Surgery

Number of PGY-1 positions: 93

Number of PGY-2 positions: None

Number of applicants: 159

Average USMLE Step 2 CK score: 250

Vascular Surgery has a 250 average score, with 159 applicants vying for 93 PGY-1 positions, and is among the most competitive medical residencies. This surgical residency program provides specialized training in diagnosing and managing peripheral vascular diseases through various surgical, endovascular, and medical treatments.

7. Neurosurgery

Number of PGY-1 positions: 243

Number of PGY-2 positions: None

Number of applicants: 373

Average USMLE Step 2 CK score: 252

The neurosurgery program offers comprehensive training and mentorship, equipping aspiring neurosurgeons with the necessary skills and knowledge required for handling matters of the brain. This rigorous surgical residency program trains physicians in complex surgical procedures focusing on the brain, spine, and peripheral nerves.

6. Interventional Radiology

Number of PGY-1 positions: 51

Number of PGY-2 positions: 125

Number of applicants: 266

Average USMLE Step 2 CK score: 253

Interventional Radiology boasts an impressive average score of 253 and attracts 266 applicants vying for just 176 available positions, establishing itself as one of the premier residency programs in its specialty. This program provides comprehensive training in cutting-edge, image-guided diagnostic and therapeutic procedures for a wide spectrum of medical conditions.

HCA Healthcare (NYSE:HCA), Pediatrix Medical Group (NYSE:MD), and Amedisys (NASDAQ:AMED) are renowned for their ability to recruit and retain top-tier medical professionals nationwide.

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