The Best Work-Life Balance Medical Specialties in 2026

For years, medical students have talked about “lifestyle specialties.”

The phrase usually refers to medical specialties that offer more predictable schedules, fewer overnight calls, less emergency coverage, higher income per hour, or more control over where and how physicians work.

But in 2026, the conversation needs to be more honest.

Work-life balance in medicine is not just about working fewer hours. It is about control. It is about whether a physician can leave work at work. It is about call burden, administrative load, emotional intensity, patient volume, compensation, flexibility, and whether the daily work still feels sustainable after ten or twenty years.

That is why the “best” work-life balance specialties are not always the easiest specialties. Many of them are highly competitive, intellectually demanding, or emotionally complex.

Dermatology, pathology, psychiatry, allergy and immunology, radiology, ophthalmology, physical medicine and rehabilitation, and certain family medicine models are often discussed as strong lifestyle options. But each specialty has tradeoffs.

The real question is not simply:

Which specialty has the best lifestyle?

The better question is:

Which specialty offers the kind of work-life balance that matches your personality, goals, competitiveness, and long-term vision of medicine?

What Does Work-Life Balance Mean for Doctors?

Work-life balance in medicine is complicated because doctors do not all work the same way.

A surgeon’s work-life balance may depend on operating room volume and call coverage. A psychiatrist’s may depend on emotional boundaries and patient acuity. A dermatologist’s may depend on clinic volume and private practice structure. A radiologist’s may depend on reading volume, night coverage, and remote work options. A family physician’s may depend almost entirely on practice model.

So when evaluating lifestyle, students should look at several factors:

Lifestyle Factor	Why It Matters
Average weekly hours	Fewer hours can help, but they do not tell the whole story
Call schedule	Night and weekend call can disrupt sleep and family life
Predictability	A predictable 50-hour week may feel better than an unpredictable 40-hour week
Administrative burden	Charting, inbox messages, prior authorizations, and paperwork often follow doctors home
Emotional intensity	Some specialties carry heavy psychological or crisis-related work
Physical demands	Surgery, OB-GYN, and emergency medicine can be physically exhausting
Compensation per hour	A high salary may feel different when adjusted for hours and stress
Flexibility	Remote work, part-time work, private practice, telemedicine, and locums can improve control
Training length	A lifestyle-friendly attending career may still require a demanding residency or fellowship
Competitiveness	Many lifestyle specialties are difficult to match into

This is why lifestyle cannot be reduced to a simple ranking.

A specialty can have excellent work-life balance for one physician and feel completely wrong for another.

The Best Work-Life Balance Specialties in 2026

Based on physician well-being data, schedule predictability, burnout patterns, compensation, call expectations, and career flexibility, these specialties stand out in 2026:

Specialty	Lifestyle Strength	Main Tradeoff
Allergy and Immunology	Predictable outpatient schedule, high satisfaction, low emergency burden	Requires fellowship after internal medicine or pediatrics
Dermatology	Regular clinic hours, high compensation, limited emergencies	Extremely competitive residency
Pathology	Lower burnout, predictable workflow, less patient-facing pressure	Less direct patient interaction, diagnostic responsibility
Psychiatry	Flexible practice models, telehealth, strong job satisfaction	Emotional intensity, complex patients
Radiology	Remote work potential, strong income, limited patient-facing work	High volume, accuracy pressure, nights in some roles
Ophthalmology	Surgical plus clinic mix, good compensation, generally controlled schedule	Competitive and technically demanding
PM&R	Focus on function, rehab, outpatient options, controllable hours	Lower public awareness, variable practice models
Family Medicine	Flexible if designed well, broad career options, high demand	Can have heavy inbox and administrative burden

The important thing is that these specialties are “lifestyle-friendly” for different reasons.

Dermatology offers predictability and high compensation. Pathology offers lower burnout and less direct patient-facing pressure. Psychiatry offers flexibility and telehealth opportunities. Allergy and immunology offers outpatient stability. Radiology offers remote work and high earning potential, but can also be intense. Family medicine can be lifestyle-friendly only when the practice model is designed well.

There is no universal winner.

There is only fit.

1. Allergy and Immunology: One of Medicine’s Quietest Lifestyle Winners

Allergy and immunology may be one of the most underrated work-life balance specialties in medicine.

It does not always get the attention of dermatology or radiology, but lifestyle data consistently places it near the top. In physician well-being surveys, allergy and immunology has ranked extremely high for physicians who believe doctors in their specialty can be happy and well-balanced.

The reasons are easy to understand.

Allergy and immunology is usually outpatient-based. Physicians often treat asthma, allergic rhinitis, food allergies, eczema, urticaria, immunodeficiency, medication allergies, and related immune conditions. The work can involve procedures such as skin testing, immunotherapy, oral food challenges, and biologic treatments, but it generally does not carry the same emergency burden as surgery, OB-GYN, or emergency medicine.

The schedule can be predictable. Nights and weekends may be limited. Many physicians work in clinic settings with more control over appointment structure. There is also room for private practice, academic medicine, pediatrics-focused allergy, adult allergy, or mixed practice.

The tradeoff is training structure. Allergy and immunology is a fellowship, not a direct-entry residency. Physicians usually complete internal medicine or pediatrics first, then pursue fellowship.

For medical students, this means allergy and immunology may not be visible early unless they actively seek exposure. But for students who like immunology, chronic disease management, patient education, outpatient care, and a more controlled lifestyle, it deserves serious attention.

Best fit for: Students who enjoy immunology, outpatient medicine, patient education, chronic disease management, and predictable clinic-based work.

Potential drawback: Less procedural intensity than some specialties, fellowship required, and fewer total training positions than larger specialties.

2. Dermatology: The Classic Lifestyle Specialty, But Not an Easy Path

Dermatology is probably the most famous lifestyle specialty in medicine.

It combines high compensation, outpatient practice, procedures, visual diagnosis, private practice opportunities, and relatively limited overnight emergencies. Many dermatologists have more predictable hours than physicians in hospital-based or surgical fields. Some build careers around medical dermatology, pediatric dermatology, dermatopathology, Mohs surgery, cosmetics, autoimmune skin disease, skin cancer, or procedural dermatology.

This is why dermatology remains so desirable.

But the lifestyle reputation comes with a major warning: dermatology is extremely competitive.

Students interested in dermatology usually need excellent academic performance, strong board scores, research, mentorship, strong clinical evaluations, and a focused application. It is not a specialty students should casually decide on late in medical school without preparation.

It is also not easy work. Dermatology requires a large diagnostic vocabulary, careful visual recognition, procedural skill, cancer detection, chronic disease management, and the ability to see high patient volumes efficiently. Cosmetic dermatology can also involve business pressure and patient expectations that are different from traditional medical care.

Still, from a lifestyle perspective, dermatology remains one of the strongest specialties in medicine.

The schedule is usually more predictable. The compensation is high. Emergencies are less common. The career paths are flexible. For physicians who enjoy the work, it can be one of the best combinations of income, autonomy, and sustainability.

Best fit for: Students who like visual diagnosis, procedures, outpatient medicine, skin disease, clinic efficiency, and long-term schedule control.

Potential drawback: Very competitive residency, high patient volume, and pressure to build a strong application early.

3. Pathology: Lower Burnout, High Intellectual Work, More Predictable Time

Pathology is often overlooked by medical students, but it deserves much more attention in work-life balance conversations.

Pathologists diagnose disease through tissue, cells, blood, laboratory data, autopsies, molecular testing, and other diagnostic systems. They may work in surgical pathology, clinical pathology, hematopathology, cytopathology, forensic pathology, molecular pathology, transfusion medicine, dermatopathology, or academic pathology.

The specialty is less patient-facing than most fields, which can be either a benefit or a drawback depending on the student.

From a lifestyle perspective, pathology can be attractive because it often has more predictable hours than acute hospital specialties. It usually has less overnight disruption than surgery, OB-GYN, emergency medicine, or critical care. Recent physician well-being data also places pathology among the specialties with lower burnout.

That does not mean pathology is easy.

The responsibility is enormous. A pathologist’s diagnosis can determine whether a patient has cancer, what treatment they receive, whether surgery was adequate, or whether a disease is benign or malignant. The work requires precision, attention to detail, pattern recognition, medical knowledge, and comfort with diagnostic uncertainty.

Pathology is a strong choice for students who love diagnosis but do not need constant direct patient interaction. It can offer a sustainable career, intellectual depth, and a central role in patient care without the same schedule chaos found in many front-line specialties.

Best fit for: Students who enjoy diagnosis, microscopy, lab medicine, cancer pathology, systems thinking, and focused analytical work.

Potential drawback: Less direct patient interaction, less public visibility, and a need for comfort with high diagnostic responsibility.

4. Psychiatry: Flexibility, Telehealth, and High Need

Psychiatry has become one of the most important lifestyle specialties to watch.

It offers a wide range of practice models: outpatient psychiatry, inpatient psychiatry, consultation-liaison psychiatry, addiction psychiatry, child and adolescent psychiatry, forensic psychiatry, emergency psychiatry, geriatric psychiatry, academic psychiatry, private practice, and telepsychiatry.

From a work-life balance perspective, psychiatry can offer strong flexibility. Outpatient psychiatrists may have more control over scheduling than many hospital-based physicians. Telepsychiatry has expanded remote and hybrid work options. Private practice can allow physicians to shape their patient mix, hours, and treatment style.

Psychiatry also has strong job satisfaction in several physician well-being reports.

But psychiatry is not “easy lifestyle medicine.”

The work can be emotionally demanding. Psychiatrists care for patients with depression, anxiety, bipolar disorder, psychosis, trauma, personality disorders, substance use disorders, suicidality, family crises, and complex social stressors. The work requires emotional boundaries, patience, communication skills, and the ability to tolerate ambiguity.

Psychiatry can offer a better schedule than many specialties, but that schedule does not eliminate emotional load.

For students who are drawn to human behavior, mental health, communication, neuroscience, and long-term patient relationships, psychiatry can be both meaningful and sustainable.

Best fit for: Students who value conversation, mental health, neuroscience, long-term care, telehealth options, and schedule flexibility.

Potential drawback: Emotional intensity, complex patients, crisis management in some settings, and boundary management.

5. Radiology: High Pay and Flexibility, But Not Always Low Stress

Radiology is often included in lifestyle specialty lists, but it deserves a more nuanced discussion in 2026.

The traditional appeal is clear. Radiology offers high compensation, intellectual challenge, diagnostic importance, technology, and in many cases less direct patient-facing work. Teleradiology and remote reading have also created flexibility that many other specialties cannot offer.

Radiologists are central to modern medicine. Emergency departments, oncologists, surgeons, neurologists, primary care physicians, and hospital teams depend on imaging interpretation. Diagnostic radiologists read X-rays, CT scans, MRIs, ultrasounds, mammograms, nuclear medicine studies, and more. Interventional radiologists perform image-guided procedures and often have a more procedural, hospital-based lifestyle.

Radiology can be lifestyle-friendly in the right model. Some radiologists work from home. Some have shift-based schedules. Some have strong compensation with less physical strain than surgery.

But radiology is not automatically low-stress.

Recent burnout data shows radiology can still have significant burnout. The workload can be intense. Radiologists may read extremely high volumes of studies under pressure. Accuracy expectations are high. Interruptions can be frequent. Night shifts and weekend coverage may be required. Teleradiology can add flexibility, but it can also create isolation and productivity pressure.

Radiology is a good example of why lifestyle should be evaluated carefully. It can be excellent. It can also be exhausting if the practice environment is built around relentless volume.

Best fit for: Students who like imaging, technology, anatomy, diagnosis, pattern recognition, focused work, and possible remote or hybrid practice.

Potential drawback: High reading volume, accuracy pressure, night coverage, isolation in some roles, and competitive matching.

6. Ophthalmology: Clinic, Surgery, and Strong Lifestyle Potential

Ophthalmology often deserves a place in the lifestyle conversation.

It combines clinic-based care with microsurgery, procedures, imaging, chronic disease management, and high-impact interventions such as cataract surgery. Many ophthalmologists treat glaucoma, diabetic eye disease, retinal disease, cataracts, corneal conditions, eye trauma, pediatric eye disorders, and vision-threatening disease.

From a lifestyle perspective, ophthalmology can be attractive because much of the work is outpatient and procedure-based. Many ophthalmologists have more predictable schedules than general surgeons or OB-GYNs. The specialty can also offer strong compensation and private practice opportunities.

However, ophthalmology is competitive and technically demanding. It requires excellent hand-eye coordination, comfort with microsurgery, and early specialty commitment. It also has its own separate match process, which students need to understand early.

Ophthalmology may not be the first specialty students think of when they hear “work-life balance,” but for the right person, it can offer one of medicine’s best combinations of procedures, income, patient impact, and schedule control.

Best fit for: Students who like vision science, microsurgery, clinic-procedure balance, precision, and outpatient specialty care.

Potential drawback: Competitive match, separate application process, and technically demanding surgery.

7. Physical Medicine and Rehabilitation: Function, Flexibility, and Quality of Life

Physical medicine and rehabilitation, often called PM&R or physiatry, is another specialty that should be taken seriously by students looking for balance.

PM&R physicians help patients recover function after injury, illness, stroke, spinal cord injury, brain injury, musculoskeletal disease, pain conditions, sports injuries, and disability. The specialty can include inpatient rehabilitation, outpatient musculoskeletal medicine, sports medicine, pain medicine, electrodiagnostics, spasticity management, prosthetics, and interdisciplinary care.

Lifestyle can vary, but many PM&R physicians have more controllable schedules than physicians in surgery, OB-GYN, emergency medicine, or critical care. Outpatient PM&R can be especially lifestyle-friendly, while inpatient rehabilitation may involve more hospital responsibilities.

PM&R also offers a different kind of medical satisfaction. It is less about a single dramatic cure and more about helping patients regain independence, mobility, function, and quality of life.

For students who enjoy anatomy, neurology, musculoskeletal medicine, patient-centered goals, and interdisciplinary teamwork, PM&R can be a strong lifestyle and purpose fit.

Best fit for: Students who like function, rehabilitation, musculoskeletal medicine, neuro-recovery, sports medicine, and patient-centered progress.

Potential drawback: Less public recognition, variable practice models, and a need to enjoy long-term functional care.

8. Family Medicine: Lifestyle-Friendly Only in the Right Model

Family medicine is complicated.

On paper, family medicine can offer flexibility, geographic freedom, shorter residency training, broad scope, outpatient practice, and strong demand. Family physicians can work in traditional primary care, urgent care, hospital medicine, rural medicine, sports medicine, geriatrics, addiction medicine, women’s health, direct primary care, concierge medicine, telemedicine, academic medicine, or administrative leadership.

That flexibility can create excellent work-life balance.

But traditional primary care can also be one of the most administratively burdened areas of medicine. Family physicians often manage large patient panels, short appointment slots, chronic disease, preventive care, mental health, medication refills, patient portal messages, insurance paperwork, prior authorizations, referrals, lab results, and documentation.

Recent burnout data shows family medicine remains one of the higher-burnout specialties.

So is family medicine a lifestyle specialty?

The honest answer is: it depends on the model.

A family physician in a well-supported team-based clinic with reasonable patient volume may have a sustainable career. A direct primary care physician may have more control over patient panel size and appointment length. A physician working urgent care shifts may have more predictable separation between work and home. A rural family physician with hospital, emergency, obstetric, and call responsibilities may have a very demanding life.

Family medicine may be one of the most flexible specialties in medicine, but flexibility is not the same as automatic balance.

For students, the key is not just choosing family medicine. It is choosing the version of family medicine that fits the life they want.

Best fit for: Students who want broad medicine, continuity, flexibility, community care, and multiple career options.

Potential drawback: Heavy inbox burden, administrative work, burnout risk, and variable schedule depending on practice model.

Specialties That Can Be Lifestyle-Friendly, But Depend Heavily on the Job

Some specialties are not always listed as top lifestyle fields, but they can offer strong work-life balance in the right setting.

Anesthesiology

Anesthesiology can offer strong compensation, shift-based work, and less clinic inbox burden. In outpatient surgery centers, the schedule may be more predictable. In major hospitals, however, anesthesiologists may have early starts, nights, weekends, OB coverage, trauma, emergencies, and heavy call.

Emergency Medicine

Emergency medicine offers shift work and fewer long-term patient panel responsibilities. When the shift ends, work may be more contained. But nights, weekends, holidays, circadian disruption, crowding, trauma, and emotional intensity can make it difficult to sustain.

Pediatrics

Pediatrics can be meaningful and often offers outpatient career paths, but compensation is lower than many specialties and administrative/family communication burden can be high. Pediatric subspecialties vary widely.

Preventive Medicine and Public Health

Preventive medicine can offer strong lifestyle and population-level impact, but it is less visible to medical students and may involve different compensation and career structures than traditional clinical specialties.

Endocrinology and Rheumatology

These internal medicine subspecialties can offer outpatient schedules and intellectual depth. However, compensation may be lower than procedural subspecialties, and chronic disease management can involve heavy documentation and patient messaging.

These specialties show why lifestyle depends on practice design.

A “bad lifestyle” specialty can sometimes become sustainable in the right job. A “good lifestyle” specialty can become exhausting in the wrong system.

The ROAD Acronym Is Outdated

Older medical students used to talk about the “ROAD” specialties: Radiology, Ophthalmology, Anesthesiology, and Dermatology.

The idea was that these specialties offered good lifestyle and strong compensation.

There is still some truth to that. But in 2026, the acronym is too simple.

Radiology can be high-paying and flexible, but burnout can be significant. Anesthesiology can offer good compensation and shift work, but call-heavy hospital jobs can be demanding. Ophthalmology can offer strong lifestyle, but it is competitive and technically intense. Dermatology still has excellent lifestyle potential, but it is one of the hardest residencies to match.

The modern lifestyle conversation should include pathology, psychiatry, allergy and immunology, PM&R, and certain family medicine models.

It should also consider administrative burden, autonomy, work from home, telemedicine, call, emotional load, and long-term sustainability.

The best lifestyle specialty is not just the one that sounds good on a student forum.

It is the one that works in real life.

Work-Life Balance Does Not Mean Low Effort

One major misunderstanding about lifestyle specialties is that they are “easy.”

That is not true.

Dermatology requires fast and accurate visual diagnosis across thousands of skin conditions. Pathology requires diagnostic precision that can determine a patient’s cancer treatment. Radiology requires constant attention and high-volume image interpretation. Psychiatry requires emotional endurance and complex communication. Allergy and immunology requires detailed immune system knowledge and careful outpatient management. Family medicine requires broad medical competence across age groups and conditions.

Lifestyle-friendly does not mean easy.

It means the structure of the work may be more sustainable.

The work can still be intense. It can still require years of training. It can still carry responsibility. It can still be competitive. It can still lead to burnout if the practice environment is poorly designed.

Students should not choose these specialties because they want an easy career.

They should choose them if they genuinely like the work and want a sustainable way to do it.

Work-Life Balance During Residency vs. After Residency

Medical students also need to separate residency lifestyle from attending lifestyle.

Some specialties with excellent attending lifestyles still have demanding training. Dermatology residency is not easy. Radiology residency requires intense studying and board preparation. Pathology requires deep diagnostic learning and often fellowship training. Psychiatry residency includes inpatient psychiatry, emergency psychiatry, consults, call, and complex patient care. Family medicine residency can include inpatient medicine, obstetrics, pediatrics, emergency medicine, clinic, and call.

The attending lifestyle may be better than residency, but students must still get through training.

This matters especially for students planning their careers strategically. A student should ask:

• How hard is it to match into this specialty?
• How demanding is residency?
• How long is training?
• Is fellowship expected?
• What is the lifestyle after training?
• What practice models are available?
• How much flexibility exists five or ten years later?

A specialty is not only a residency. It is a long-term career structure.

What This Means for Caribbean Medical School Students

For students at Saint James School of Medicine and other Caribbean medical schools, lifestyle specialties require careful planning.

Many of the best work-life balance specialties are competitive. Dermatology, ophthalmology, radiology, and some subspecialty paths can be challenging for international medical graduates. That does not mean they are impossible, but students need to be realistic.

A Caribbean medical school student interested in a lifestyle-friendly specialty should start early.

That means strong academic performance, serious USMLE preparation, strong clinical rotations, excellent letters of recommendation, research or scholarly activity when relevant, and honest specialty advising.

It also means understanding which lifestyle paths may be more strategically realistic.

For example, a student interested in allergy and immunology may first pursue internal medicine or pediatrics, then apply for fellowship. A student interested in psychiatry may build a strong psychiatry-focused application with relevant rotations, letters, and experience. A student interested in pathology should seek exposure early because many students do not fully understand the specialty until late. A student interested in family medicine can think carefully about future practice models that protect sustainability.

Lifestyle goals are valid.

But they still need a plan.

For Caribbean medical school students, the strongest approach is not to chase a specialty because it has a reputation. The strongest approach is to understand the daily work, the match competitiveness, the training pathway, and the long-term practice options.

A good lifestyle specialty is only good if you can realistically enter it and enjoy the work once you get there.

How to Choose a Specialty for Work-Life Balance

Students who care about work-life balance should ask better questions during medical school.

Not just:

“Which specialty has the best lifestyle?”

But:

• What does a normal week look like?
• How often do physicians take call?
• Do they work nights, weekends, or holidays?
• How much charting happens after hours?
• How much control do they have over their schedules?
• Can they work part-time?
• Can they work remotely?
• How common is burnout?
• What is the compensation per hour, not just annual salary?
• How emotionally draining is the work?
• How physically demanding is the work?
• How does the lifestyle change after residency?
• Do physicians in this specialty seem happy 10 years into practice?

Clinical rotations are the best place to observe these answers.

Watch the attendings. Watch the residents. Notice who is exhausted. Notice who seems fulfilled. Notice who has control over their time. Notice who is always behind on documentation. Notice who is constantly interrupted by call. Notice who still enjoys teaching.

Specialty choice is not just about what subject you like.

It is about what life you are choosing.

Final Takeaway: The Best Lifestyle Specialty Is the One You Can Sustain

In 2026, the strongest work-life balance specialties include allergy and immunology, dermatology, pathology, psychiatry, radiology, ophthalmology, PM&R, and certain family medicine models.

But none of these specialties is perfect.

Dermatology has excellent lifestyle potential, but it is highly competitive. Pathology has lower burnout, but less direct patient interaction. Psychiatry has flexibility, but emotional intensity. Radiology has remote work potential, but high volume and accuracy pressure. Allergy and immunology has outpatient stability, but requires fellowship. Family medicine can be flexible, but only when the practice model protects physicians from overwhelming administrative burden.

The best work-life balance specialty is not simply the one with the fewest hours.

It is the one where the work, schedule, compensation, emotional load, competitiveness, and long-term career options match the life you want to build.

For future physicians, that is the real goal.

Not an easy career.

A sustainable one.

By Praveen Renumala, MD, Associate Executive Dean

FAQ

What medical specialty has the best work-life balance in 2026?

Allergy and immunology, dermatology, pathology, psychiatry, radiology, ophthalmology, PM&R, and some family medicine models are often considered among the best specialties for work-life balance. The best choice depends on how a physician defines balance.

Is dermatology still the best lifestyle specialty?

Dermatology remains one of the strongest lifestyle specialties because it often offers predictable outpatient hours, high compensation, procedures, and limited emergencies. However, dermatology is extremely competitive to match into.

Is psychiatry a good specialty for work-life balance?

Yes, psychiatry can offer strong flexibility, especially in outpatient practice, telepsychiatry, and private practice. However, the work can be emotionally demanding.

Is pathology good for work-life balance?

Pathology is often one of the lower-burnout specialties and may offer more predictable schedules than many patient-facing or hospital-based specialties. It is best suited for students who enjoy diagnosis, laboratory medicine, and detailed analytical work.

Is radiology a lifestyle specialty?

Radiology can offer strong compensation, remote work options, and schedule flexibility. However, it can also involve high case volume, night coverage, productivity pressure, and significant burnout in some practice settings.

Is family medicine good for work-life balance?

Family medicine can offer excellent flexibility, but it depends heavily on the practice model. Traditional primary care can involve heavy administrative burden, inbox work, and burnout. Direct primary care, urgent care, telemedicine, academic medicine, and team-based models may offer more control.

Which medical specialties are usually the most stressful?

Emergency medicine, OB-GYN, surgery, urology, cardiology, hematology-oncology, gastroenterology, and some hospital-based specialties often report higher stress or burnout, depending on the data source and practice setting.

Should medical students choose a specialty based on lifestyle?

Lifestyle should be part of the decision, but not the only factor. Students should also consider interest, ability, competitiveness, patient population, training length, compensation, emotional fit, and long-term career sustainability.

What lifestyle specialties are realistic for IMGs?

Psychiatry, pathology, family medicine, internal medicine followed by allergy and immunology, and some radiology pathways may be possible for strong IMG applicants, depending on academic performance, USMLE scores, clinical experience, letters, visa status, and specialty strategy. Dermatology and ophthalmology are possible but highly competitive.