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Derm is competitive because of:
1) Great lifestyle. There aren't a whole lot of dermatological emergencies that require you to be on call.
2) Lots of money. Most dermatologists are doing a lot of different procedures - like botox - which aren't covered by insurance companies so the market dictates the cost not the insurance companies.
3) There are very few residency spots, so supply is very low. This is what amps up the competitiveness, while the first two things I mention are what have driven up demand.
I personally don't understand it entirely. While I certainly want a good lifestyle and good money, I also want to be interested in the medicine I'm doing...one look at a clinical derm book was enough to sour me on the whole field - just disgusting picture after disgusting picture. I guess some people are able to put aside that aspect in order to focus on the money.
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