I was doing some research to find out which residencies are the most competitive. I haven’t decided on a residency for myself yet; I am trying to keep an open mind until I do my rotations. I have to add that these rankings are subjective, because the selection process can vary greatly. This is what I came up with in order of most to less competitive residency fields/programs:

 
1. Plastic Surgery
2. Dermatology
3. Neurosurgery
4. Otolaryngology
5. Orthopedics
6. Radiation Oncology
7. Anesthesia
8. Diagnostic Radiology
9. General Surgery
10. Internal Medicine / Pediatrics

Also, these numbers here are two years old (2009), courtesy of AAMC:

Unfortunately it’s getting harder to secure a great residency each year even though there will be a significant physician shortage in the near future. Currently, there is a shortage of 13,700 in physicians. By comparison, in 2020, there will be 759,800 physicians (in all specialties) yet a demand of 851,300 physicians, essentially a shortage of 91,500 doctors, according to the AAMC. As paradoxical as this sounds, it’s true. This is especially true for primary care physicians, but also in other specialties.

While medical schools are expanding, upping the number of graduates, residency slots have remained the same. Proposed cuts in Medicare, the primary source of graduate medical education funding, could further worsen the situation.

The reason for the discrepancy right is simply the amount of money that a physician will earn depending on the specialty. While primary care is challenging and highly stressful, it unfortunately offers only roughly 25% of the pay that might be earned in neurosurgery. Medical students, usually deeply buried in debt, often naturally choose a specialty that will free them of their debt sooner rather than later.