Top 5 Least Competitive Medical Specialties (UK Edition)

Updated on: December 3, 2023
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Written By Dr Ollie

Every article is fact-checked by a medical professional. However, inaccuracies may still persist.

The process of choosing the right medical specialty can be overwhelming, especially when considering the competitiveness of each one.

Although I don’t think competition ratios should by any means be your sole deciding factor, if you are trying to decide on a career path in medicine it doesn’t hurt to include them when weighing up your options.

The least competitive medical specialties in the UK include psychiatry, general practice, genitourinary medicine, geriatrics and palliative medicine. Exactly how competitive it is to enter training in any given specialty will vary from year to year but these fields tend to be less fiercely fought over.

In this article, I’m going to look at each of these 5 specialties in turn, describe what that type of doctor does, how you can enter training in the field and why it tends to be less competitive compared to other areas of medicine.

The Least Competitive Types Of Doctor

It’s very easy to look up the competition ratios for any given specialty’s training pathway in any given year.

However, these figures:

  1. Change from year to year; and
  2. Don’t tell the whole story

For example, the competition ratio for a Community and Sexual Reproductive Health ST1 job pretty much halved from 2021 to 2022, going from 27.83 : 1 to 15.31 : 1.

Did community sexual health suddenly become far less popular amongst British junior doctors?

Not at all. The number of jobs available simply doubled.

Equally, the competition ratio for maxillofacial surgery ST3 jobs generally sits at just above 1. Does this make this an incredibly low-competition specialty?

Definitely not. Considering the fact you need both a medical and dental degree to apply, it simply means the applicant pool is incredibly highly selected.

It’s actually even on my list of most competitive medical specialties.

From my time working as a doctor, talking to colleagues, discussing specialty applications and looking at the data, I can say as a general trend, the following 5 specialties tend to be less competitive than many others:

  1. Psychiatry
  2. General Practice
  3. Genitourinary Medicine
  4. Geriatrics
  5. Palliative Medicine

This is somewhat based on recent years’ competition ratios, but it’s also taking into account lots of other factors that the numbers can miss.

Least Competitive Medical Specialties Pixel Infographic

It’s a ranking that’s by no means set in stone, but one that’s simply meant to give you a rough idea of some areas of medicine that can be a little easier to break into.

In this next section, I’m going to take a bit of a closer look at each of the specialties listed.

Psychiatry

A psychiatrist is a highly trained doctor who specialises in the diagnosis, treatment, and management of mental health disorders.

Typically, a psychiatrist engages in thorough assessments and examinations to accurately identify mental health conditions.

These assessments involve conducting interviews, gathering medical histories and employing psychological tests and evaluations. Drawing upon their training in psychiatry, they skillfully evaluate symptoms, analyse their origins, and make accurate diagnoses.

Once a diagnosis has been established, a psychiatrist formulates a personalised treatment plan tailored to the individual’s specific needs. This plan may encompass various approaches, including psychotherapy, medication management, and lifestyle modifications.

Through regular therapeutic sessions, psychiatrists provide a safe and non-judgmental environment for patients to explore their thoughts, emotions, and behaviours, aiming to foster self-awareness and facilitate positive change.

How To Become A Psychiatrist

  • Medical school (4-6 years)
  • Foundation training programme (2 years)
  • Core psychiatry training (3 years)
  • Higher psychiatry training (3 years)

Why Psychiatry Isn’t Generally Competitive

While psychiatry can offer an excellent work-life balance compared to many other specialties, it can be emotionally demanding.

Working with patients who suffer from severe mental illnesses and witnessing their struggles can easily take a toll on a doctor’s well-being.

This emotional burden of dealing with complex cases and the potential for burnout may deter some doctors from entering the field.

Psychiatry also requires excellent communication and interpersonal skills- establishing trust and rapport with patients is crucial for effective treatment. Some doctors may feel that their strengths lie in other areas of medicine, where technical skills and procedures take precedence over extensive patient interaction.

Additionally, the nature of psychiatric disorders poses unique challenges in diagnosis and treatment. Unlike some physical ailments, mental health conditions are often complex and multifaceted, requiring long-term therapy and collaboration with other healthcare professionals.

Some doctors may prefer specialties that offer more immediate and tangible results or focus on specific organ systems with easy fixes.

General Practice

General practitioners play a crucial role in the NHS. They’re pretty much the go-to person for all things health-related and the public’s first port of call when they become unwell.

Although they’ve got ‘general’ in their name, GPs are in fact highly trained doctors who are knowledgeable about a vast range of medical conditions.

They don’t have specialist knowledge about one area of medicine, but rather they’re experts in diagnosing and treating common illnesses and injuries.

Whether you have a nagging cough, a persistent headache, or need a check-up, your GP is the doctor you’ll likely see.

But it’s not just about treating illnesses: GPs are also great at preventive care.

They focus on keeping their local population healthy and provide regular check-ups, vaccinations, and screenings to anyone with a chronic condition.

How To Become A GP

  • Medical school (4-6 years)
  • Foundation training programme (2 years)
  • GP training (3 years)

Why General Practice Isn’t Generally Competitive

I personally want to become a GP. However, I can understand why some of my colleagues are put off from doing the same!

General practice encompasses a broad range of medical conditions and requires a wide knowledge base, which can make it less appealing to those who seek the depth and complexity of a specific specialty.

Specialising in one particular field, such as cardiology, surgery or neurology, can provide the opportunity for more in-depth knowledge, mastery of specific procedures, and potentially a greater sense of professional fulfilment.

Working as a GP in the NHS can also be incredibly challenging in terms of workload and time management.

General practitioners often have a large patient population and are responsible for addressing a wide variety of health concerns.

The need to balance numerous appointments, paperwork, and administrative tasks can lead to a high level of stress and limited time for individual patients.

General practice can also involve long working hours and potentially an on-call commitment, although this somewhat varies depending on where you work.

Genitourinary Medicine

A genitourinary medicine (GUM) consultant, also known as a sexual health consultant, plays a vital role in diagnosing, managing, and treating a wide range of sexual health issues and infections.

Their expertise lies in the prevention, diagnosis, and treatment of conditions related to the genital and urinary systems, including sexually transmitted infections (STIs) and HIV/AIDS.

GUM consultants also offer counselling and advice on sexual health matters, including contraception, safer sex practices, and partner notification.

Moreover, GUM consultants perform diagnostic tests, such as blood tests, urine tests, and swabs, to accurately diagnose STIs and other genitourinary conditions. They interpret test results and develop personalised treatment plans tailored to each patient’s needs.

GUM consultants may also collaborate with community organisations and participate in public health initiatives to promote sexual health awareness, education, and prevention.

A doctor takes an STI swab from a patient

How To Become A GU Consultant

  • Medical school (4-6 years)
  • Foundation training programme (2 years)
  • Core medical training (2 years)
  • GUM specialty training (4 years)

Why Genitourinary Medicine Isn’t Generally Competitive

There’s no getting around the fact that GUM requires a high level of comfort and expertise in discussing sensitive and intimate topics related to sexual health.

Some doctors may just feel more inclined towards specialties that involve less personal and potentially uncomfortable patient interactions.

Managing sexually transmitted infections (STIs), HIV/AIDS, and other related conditions requires a comprehensive understanding of infectious diseases and a commitment to staying up-to-date with evolving treatment guidelines. This can be challenging for doctors who prefer a more focused or procedural-oriented specialty.

GUM clinics often face challenges related to limited resources, long waiting lists, and high patient volumes. The demand for sexual health services may outstrip available staff and facilities, resulting in a potentially overwhelming workload and reduced job satisfaction.

Additionally, GUM can be emotionally demanding due to the nature of the conditions treated.

Doctors in this field may frequently encounter patients who are experiencing distress, stigma, or mental health issues related to their sexual health. This emotional burden can deter some doctors from specialising in genitourinary medicine.

Geriatrics

A geriatrician, also known as a geriatric physician or specialist, is a medical doctor who focuses on the healthcare needs of older adults.

Geriatrics addresses the unique challenges and health issues that arise with advancing age. Geriatricians are experts in providing comprehensive care to elderly patients, promoting healthy ageing, and managing complex medical conditions that commonly affect older individuals.

Geriatricians take into account patients’ medical history, physical and cognitive abilities, lifestyle, and social factors to create a holistic approach to their care.

They focus on maintaining functional independence, optimising quality of life, and enhancing overall well-being for their patients.

Geriatricians address a wide range of health concerns faced by older adults, such as chronic diseases (like arthritis, diabetes, and heart disease), cognitive impairments (such as dementia and Alzheimer’s disease), mobility issues, falls, and age-related frailty.

They provide medical management, prescribe appropriate medications, monitor for adverse drug reactions, and coordinate specialised care, such as physical therapy or geriatric psychiatry.

How To Become A Geriatrician

  • Medical school (4-6 years)
  • Foundation training programme (2 years)
  • Core medical training (2 years)
  • Geriatrics specialty training (4 years)

Why Geriatrics Isn’t Generally Competitive

The complexities of treating elderly patients with multiple chronic conditions, polypharmacy, and age-related physiological changes can be challenging.

Some doctors may simply prefer a field that offers a narrower focus or specialises in specific organ systems rather than the broad scope of geriatric medicine.

Geriatrics also often involves dealing with end-of-life care and the emotional challenges associated with caring for patients nearing the end of their lives.

Witnessing the decline and loss of patients can be emotionally taxing for doctors and some may prefer to focus on specialties that offer a greater potential for positive outcomes and long-term patient relationships.

Additionally, geriatric care can be time-consuming and resource-intensive. Older patients often require comprehensive assessments, coordination of care among multiple specialists, and involvement of other healthcare professionals.

I can imagine the administrative burden and limited resources in the field could easily impact a doctor’s decision to specialise in the area.

Palliative Medicine

Palliative medicine consultants specialise in providing comprehensive medical care and support to patients who are facing terminal conditions, aiming to improve their quality of life and alleviate suffering.

The responsibilities of a palliative medicine consultant encompass a wide range of tasks. They conduct thorough assessments to evaluate the physical, emotional, and psychological needs of patients, considering the impact of their illness on their overall well-being.

They work closely with a multidisciplinary team, including nurses, social workers, and chaplains, to develop personalised care plans that address each patient’s unique requirements.

Palliative care consultants are skilled in pain and symptom management, utilising various approaches to alleviate distressing symptoms such as pain, nausea, and breathlessness.

They ensure that patients receive appropriate medication and treatments tailored to their specific needs. Moreover, these specialists provide guidance and support to patients and their families, helping them make informed decisions about treatment options, advance care planning, and end-of-life care.

How To Become A Palliative Medicine Consultant

  • Medical school (4-6 years)
  • Foundation training programme (2 years)
  • Internal Medical Training (3 years)
  • Palliative medicine specialty training (4 years)

Why Palliative Medicine Isn’t Generally Competitive

Palliative medicine is arguably the most emotionally demanding specialty on this list.

Doctors often witness patients’ suffering and frequently need to have difficult conversations about prognosis and advance care planning.

I think it’s fair to say many people, myself included, prefer specialties that offer a more positive and proactive approach to treatment and recovery.

Just due to the very nature of palliative medicine, those working in the field can find it emotionally draining which may lead to compassion fatigue or even burnout.

Dealing with the death and dying of patients on a regular basis can easily take a toll on a doctor’s mental and emotional well-being.

This aspect alone may deter many doctors from specialising in palliative medicine, despite the many hugely rewarding aspects of the job

Final Thoughts

There’s no point in entering a specialty and following a career path just because it was easy to get into if you don’t enjoy it.

I genuinely enjoy working in general practice and it’s just a bonus to me that it’s one of the less competitive specialties.

It’s also important to note that just because a specialty is less competitive doesn’t mean it’s less important or less rewarding.

Each specialty has its own unique challenges and opportunities, regardless of how easy or hard it is to get into, and I strongly believe it’s important to choose a specialty that aligns with your personal and professional goals no matter the competition ratios.

About the author
After studying medicine at the University of Leicester, Dr Ollie now works as a junior doctor in London. His interests include medical education and expedition medicine, as well as having a strong belief in the importance of widening access to medicine.