Last year I tried to take a guess at the competitiveness of the larger specialties in Canada. I even went so far as to put numbers to my guesses. My accuracy was... not good. At least, it wasn't quantitatively good. It was a popular post nevertheless, so I suppose my random speculation has some minor value. This year, however, I'll be making my predictions a bit more qualitative, to spare myself the embarrassment of my quantitative imprecision!
I'll also avoid the specialty-by-specialty analysis. Unfortunately most specialties don't change much in a year, so when I started doing so, I just ended up repeating myself quite a bit. Instead, I'll lump specialties together by my expectations of changes in their competitiveness relative to the last couple years.
Increased Interest, Mild-to-Moderately Increased Competitiveness
In this category: Internal Medicine, Physical Medicine and Rehabilitation, Diagnostic Radiology, Radiation Oncology.
Diagnostic Radiology has had a few years of being relatively uncompetitive, but interest in the field appears to be back up a bit this year. Radiation Oncology has suffered with a terrible job market, but it seems to be improving somewhat, driving some interest back into this relatively well-paying, good lifestyle specialty. Internal Medicine saw a large jump in interest last year relative to its medium-term average and that seems to have been maintained this year, benefiting from decreased interest both in surgical specialties as well as Family Medicine. PM&R shockingly became one of the most competitive specialties last year and I do not expect that to change at all. Good lifestyle, alright pay, unique and interesting work makes it very attractive and so it was long regarded as a hidden gem of specialties. It's no longer hidden and so I expect a competitive match to PM&R this year, likely comparable to last year.
Similar Interest, Decreased Positions, Mildly Increased Competitiveness
In this category: Anesthesiology, OBGYN, most surgical specialties.
Pretty much every specialty involving being in the operating room is seeing a small reduction in residency spots this year, with Plastic Surgery (slight increase) and Urology (no change) being the exceptions. Overall interest in surgical specialties has been steadily declining over the past decade, but seems to be plateauing. In response to a weak job market, positions in these fields have been cut. The sum of this is that even with the new nadir of interest, overall competitiveness may, if anything, increase. Would-be surgeons, OBGYNs and anesthesiologists look to continue to have their work cut out for them to match.
Top-Tier of Competitiveness, Unlikely to Change
In this category: Dermatology, Plastic Surgery, Emergency Medicine.
These three specialties have solidified themselves as being uniquely competitive and that doesn't look to change much this year. ENT or Ophthalmology are competitive enough at baseline that in an odd year they might squeeze ahead of one of the three, but it'd be a temporary (and unexpected) blip for that to occur this year. PM&R also has an outside shot at being more competitive than these three given its huge increase in popularity last year, but I'm expecting these three to stay clustered at the top this cycle.
Similar Interest, Small Increase in Positions, Similar Competitiveness
In this category: Family Medicine, Psychiatry
When one specialty loses residency positions, another tends to gain them. Family Medicine and Psychiatry are those specialties, reflecting the higher demand for physicians in these fields. For Family Medicine, this comes on the heels of a successful decades-long push to get more medical students into family practice, combined with slowly increasing numbers of residency spots. Last year was the first year in a decade where interest in Family Medicine declined. Family Medicine has never been competitive by any metric, and I don't expect this year to be much different. Psychiatry, in contrast, has become a little more competitive in recent years and is no longer the near-guaranteed match it used to be. It's a unique field, however, and continues to have low pay despite a stellar job market. There's a limit to how much interest the field can generate for itself, so I would expect the additional positions to make Psychiatry a bit less competitive this year than last year.
For the most part, specialty competitiveness will stay roughly where it was last year. Large, dramatic swings in competitiveness tend to be statistical anomalies in smaller specialties. More often, changes in specialty competitiveness take place over the course of several years with slow, incremental adjustments, reflecting change job markets, working conditions, or pay, each of which change fairly slowly as well. I have not heard any word of any particular specialties being dramatically different from previous years beyond the normal year-to-year variations. I've been surprised in the past, however... we'll see how well it turns out this year!
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