Finishing up 2nd year as a neurosurgery attending, ask me anything

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Regarding your publications, were these gained during med school? And what fields were they in? Neurosurgery??
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imadome said:
Prior to medical school, how much exposure did you have to neuroscience? I had no exposure in undergrad and my medical school doesn't have any researchers in neurosurgery specifically (although we have a few that do bench research in neuroscience). The only exposure I get is from shadowing neurosurgeons at the local hospital. I plan to do an away rotation in neurosurgery though. Did you have significantly more experience than this before matching?
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I had no neuroscience background before medical school. I did a lot of research in medical school but no other major clinical experience beyond rotations.
 
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Could you give us a run down of your average week in terms of hours and call? I know call changes from intern to PGY-2 but I am curious how it all works. Thank you for your time.
 
mmmcdowe said:
All medical school and all neurosurgery.
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1. Did you have much research experience before medical school?

2. What kind of research was most of this? Case reports, other clinical, basic?

Sorry just trying to guess how to be productive in a few months.
 
idkwhattodomkay said:
Could you give us a run down of your average week in terms of hours and call? I know call changes from intern to PGY-2 but I am curious how it all works. Thank you for your time.
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As a neurosurgery intern you spend part of the year on service and part off service. off service hours vary tremendously from rotation to rotation. You may do night float as an off service as long as it doesnt violate work hours. For example I am on neuro oncology clinic and consults right now and that is 8am to 6pm Monday through friday. I will be finishing the year up on 2 weeks of neuro night float sunday through friday 6pm to 7am.

On neurosurgery interns do not take call at my institution. Rounds are at 6am and signout is at 7PM. You show up early enough to preround but the time varies. When the service is large I came in at about 4am. When it was small I came in at 5am. Leaving in the evening is variable. On a slow day one resident would stay and the others would leave. On a busy day you might stay later, especially if ORs are still going. You get one weekday off a week ands the interns would alternate staying late, so you effectively got a day and a half off each week.
 
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Blue Blood said:
1. Did you have much research experience before medical school?

2. What kind of research was most of this? Case reports, other clinical, basic?

Sorry just trying to guess how to be productive in a few months.
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1. Nothing related to medicine. No publications or anything of note, just some animal behavior stuff.

2. Nothing basic science. A combination of clinical outcomes projects, a little bit of genetics stuff, a few case reports and series, and a few reviews.

The best way to be productive is to focus on getting involved in things you find interesting and enjoyable. Work hard and you will be rewarded with more work.
 
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I was going to PM but I figured others might learn something from your answer. I am interested in neurosurgery but am somewhat intimidated. Many of the attendings and residents at my institution seem like they hate their life and I don't seem to get along with many of them (different personalities). Some others are sort of nice with the occasional awesome person thrown in. I know I have what it takes to learn the trade but to be honest I don't want to be miserable like many here. I would hate to go to work for 7 years in this environment and I worry many other programs are similar. I am sure some places are great, but how do I get exposure to those that love their job and don't take out their misery on us worthless med students? What advice do you have for someone unsure if they have the balls to give up a significant portion of their life to do neurosurgery but are still interested in it? I apologize for the vague questions but I'm not sure how else to word them. Thanks!
 
idkwhattodomkay said:
I was going to PM but I figured others might learn something from your answer. I am interested in neurosurgery but am somewhat intimidated. Many of the attendings and residents at my institution seem like they hate their life and I don't seem to get along with many of them (different personalities). Some others are sort of nice with the occasional awesome person thrown in. I know I have what it takes to learn the trade but to be honest I don't want to be miserable like many here. I would hate to go to work for 7 years in this environment and I worry many other programs are similar. I am sure some places are great, but how do I get exposure to those that love their job and don't take out their misery on us worthless med students? What advice do you have for someone unsure if they have the balls to give up a significant portion of their life to do neurosurgery but are still interested in it? I apologize for the vague questions but I'm not sure how else to word them. Thanks!
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One of the most important parts of choosing a specialty beyond general interest is fit with the people in that specialty. They are going to be your mentors and your colleagues and you are going to spend decades of your life with them. I had many interests in medicine including neurology, radiology, ED, etc. In fact, there were very few aspects of medicine that I didn't enjoy, but I resonated best with the people in neurosurgery. If you don't resonate with the people in your program, it could be a fluke (there are definitely variants throughout the country), but it also makes it a harder choice for you because you have to take it on faith that they are the outlier in the field and not you. The best thing to do would be to do sub-is at programs with benign reputations and see if you are a better fit and not rank any program that you think you would be so miserable at that it wouldn't be worth suffering through.
 
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When you say 10-20 papers are you saying 10-20 peer reviewed publications in journals or are you saying 10-20 publications in the sense of the ERAS publications of posters, presentations, book chapters, abstracts, etc. (like 5 oral presentations, 10 posters, and 5 papers would be 20 pubs) because 10-20 peer reviewed publications that origianated in med school is very high and is not the norm so we dont want to scare people off that are shocked that they only have 4 papers lol
 
mmmcdowe said:
One of the most important parts of choosing a specialty beyond general interest is fit with the people in that specialty. They are going to be your mentors and your colleagues and you are going to spend decades of your life with them. I had many interests in medicine including neurology, radiology, ED, etc. In fact, there were very few aspects of medicine that I didn't enjoy, but I resonated best with the people in neurosurgery. If you don't resonate with the people in your program, it could be a fluke (there are definitely variants throughout the country), but it also makes it a harder choice for you because you have to take it on faith that they are the outlier in the field and not you. The best thing to do would be to do sub-is at programs with benign reputations and see if you are a better fit and not rank any program that you think you would be so miserable at that it wouldn't be worth suffering through.
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This makes a lot of sense. Thank you.
 
Merely said:
When you say 10-20 papers are you saying 10-20 peer reviewed publications in journals or are you saying 10-20 publications in the sense of the ERAS publications of posters, presentations, book chapters, abstracts, etc. (like 5 oral presentations, 10 posters, and 5 papers would be 20 pubs) because 10-20 peer reviewed publications that origianated in med school is very high and is not the norm so we dont want to scare people off that are shocked that they only have 4 papers lol
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10-20 peer reviewed publications not counting book chapters, posters, or presentations. In a big lab those are a dime a dozen and I only listed abstracts/talks/posters where I was first or second author in order to prevent the others from diluting the actual stuff where I contributed significantly. I never said it was the norm, I said top applicants for the big academic programs tended to average around 5 with most under 10 but outliers all the way up to 80. People with less get in based on other strengths certainly, and I would say the average applicant pool as a whole has 1-3. I was very lucky, started early, and had a proliferate mentor.
 
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hey man--so I know this question has been answered before but how much of a disadvantage am I by not attending a school with no home program? I'm entering medical school with 10 pubs, hope to get about 5-10 more before applying for residency (assuming I stay interested in nsg). I've spent 2 summers in college and 2 years post-grad doing research/shadowing in 4 different departments (2 of those considered 'top tier'). I feel like I've made solid connections with a lot of people but I don't want my app to tossed/looked down upon at a top program like yours just because I come from a smaller school. I'm just a little afraid because some top academic programs tend to in-bred/consistently select applicants from top 10 schools. I want to attend a bigger program because I have a strong interest in academic neurosurgery, while hopefully getting solid operative experience.

I know I'd have to do 3 aways. Currently I'm hoping to treat one of the four depts I'm plugged in at as my "home away home" by keeping in close contact with faculty and rotating through their first. Would love to hear your thoughts, especially since I feel my position may be a little unique.
 
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When did you become interested in nsurg? I'm an incoming M1 and I'm unsure of what specialty I want. You said you didn't know before you entered medical school but figured it out along the way. When should I have my mind set? How was it possible for you to complete all your classes successful and the research that are both integral to a strong applicaiton? What was your biggest obstacle/how you overcame it? I have no previous research and I feel as though I'm behind.
 
Statistically the most likelybprogram to match is your home program so yeah it is a bit of a disadvantage. That being said subis are your second most likely and most students match elsewhere overall (just not at any one specificly )so it isnt insurmountable task. Most ptrograms are more interested in the applicant rather than their home program, but yes some very small number of programs do get inbred and this is mostlty because they have had such a good track record. Your situation isnt super uncommon just do your best and stay involved.

surgeonhands2213 said:
hey man--so I know this question has been answered before but how much of a disadvantage am I by not attending a school with no home program? I'm entering medical school with 10 pubs, hope to get about 5-10 more before applying for residency (assuming I stay interested in nsg). I've spent 2 summers in college and 2 years post-grad doing research/shadowing in 4 different departments (2 of those considered 'top tier'). I feel like I've made solid connections with a lot of people but I don't want my app to tossed/looked down upon at a top program like yours just because I come from a smaller school. I'm just a little afraid because some top academic programs tend to in-bred/consistently select applicants from top 10 schools. I want to attend a bigger program because I have a strong interest in academic neurosurgery, while hopefully getting solid operative experience.

I know I'd have to do 3 aways. Currently I'm hoping to treat one of the four depts I'm plugged in at as my "home away home" by keeping in close contact with faculty and rotating through their first. Would love to hear your thoughts, especially since I feel my position may be a little unique.
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gocavs said:
When did you become interested in nsurg? I'm an incoming M1 and I'm unsure of what specialty I want. You said you didn't know before you entered medical school but figured it out along the way. When should I have my mind set? How was it possible for you to complete all your classes successful and the research that are both integral to a strong applicaiton? What was your biggest obstacle/how you overcame it? I have no previous research and I feel as though I'm behind.
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I was by no means totally committed, but I decided to focus on nsg because it was the thing that was most competitive and I decoded that I would rather prepare rather than decide later and not be prepared. I didnt decide til third year. It is all about finding your balance. You arent behind I never did medical research in college. Just breath and find your balance first. Afterwards, you can use your free time as youbfeel approproate. My biggest obstacle was breaking myself of thd dependency of others to solve eesearch problems because no one cares about your projects as much as you do.
 
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mmmcdowe said:
Statistically the most likelybprogram to match is your home program so yeah it is a bit of a disadvantage. That being said subis are your second most likely and most students match elsewhere overall (just not at any one specificly )so it isnt insurmountable task. Most ptrograms are more interested in the applicant rather than their home program, but yes some very small number of programs do get inbred and this is mostlty because they have had such a good track record. Your situation isnt super uncommon just do your best and stay involved.
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Ok cool, I guess I was referring to the unique part being I've been lucky to have been so productive in research pre-medical school (10 pubs and 15 + abstracts) but am attending a school with no home program. Thanks for the response!
 
surgeonhands2213 said:
Ok cool, I guess I was referring to the unique part being I've been lucky to have been so productive in research pre-medical school (10 pubs and 15 + abstracts) but am attending a school with no home program. Thanks for the response!
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If your publications were neurosurgery they will be considered more favorably even though they were in undergrad, but you are also going to be expected to continue to be productive in medical school. If you don't, then they may interpret that as you are no longer interested in academics.
 
mmmcdowe said:
If your publications were neurosurgery they will be considered more favorably even though they were in undergrad, but you are also going to be expected to continue to be productive in medical school. If you don't, then they may interpret that as you are no longer interested in academics.
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I definitely plan to continue research. And yeah, they've all been in Neurosurgery!
 
Would you say 250+ on step 1(plus research etc.) will get you into any top tier program?
 
Just to add a bit more to that now that I have some free time its called a match for a reason. The places you had in mind for the top of your rank list will very likely drastically change after youve been on the trail. At least one program not on your radar is going to wow you and at least one that you had high hopes for will disapppont. There is no best residency program, all have pros and cons and its about finding the one with the strengths that you vaalue most and the weaknesses that you care least about.
 
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mmmcdowe said:
Just to add a bit more to that now that I have some free time its called a match for a reason. The places you had in mind for the top of your rank list will very likely drastically change after youve been on the trail. At least one program not on your radar is going to wow you and at least one that you had high hopes for will disapppont. There is no best residency program, all have pros and cons and its about finding the one with the strengths that you vaalue most and the weaknesses that you care least about.
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Thanks! I attend an institution without a neurosurgery program and have found it hard to find neurosurg research opportunities at the nearby institution. The other "requirements" I have or am currently working on.
 
Do surgeons crack their knuckles? What about during a surgery? Have you ever seen or heard anyone letting go of the tools so they could move their hands around?
 
Make Or Break said:
Do surgeons crack their knuckles? What about during a surgery? Have you ever seen or heard anyone letting go of the tools so they could move their hands around?
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Yes surgeons crack their knuckles, for exceptionally involved and long surgeries I don't think it is abnormal for someone to stretch or do other tension relieving actions.
 
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I'm an undergrad with a prosthetic eye. This affects my depth perception a bit. Not enough to affect normal, every day life, things like driving, or sports/my hand-eye coordination; however, on occasion this can mess with my ability to make small movements precisely (ie, I'll slightly over or under-shoot reaching for something, never by more than a half inch or so). I've always been fascinated by the brain and would love to eventually be a neurosurgeon (lots of steps between then and now, I know), but am competitive enough to want to excel in whatever field I end up in. Do you think that this would hinder my ability to successfully perform neurosurgical operations?
 
scoops619 said:
I'm an undergrad with a prosthetic eye. This affects my depth perception a bit. Not enough to affect normal, every day life, things like driving, or sports/my hand-eye coordination; however, on occasion this can mess with my ability to make small movements precisely (ie, I'll slightly over or under-shoot reaching for something, never by more than a half inch or so). I've always been fascinated by the brain and would love to eventually be a neurosurgeon (lots of steps between then and now, I know), but am competitive enough to want to excel in whatever field I end up in. Do you think that this would hinder my ability to successfully perform neurosurgical operations?
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This is actually an interesting question that I saw debated amongst several surgical specialties represented by a program director each. Some fields advocated for visual testing as a prerequisite for surgical training. Others were less concerned. The truth of the matter is that it could very well affect your surgical ability. Whether or not this is protected under the americans with disabilities act is unclear because there are limitations. When you apply for residency you sign form attesting that you could physically perform all needed tasks. Some people might interpret binocular vision as absolutely necessary, but I imagine that as a whole it wouldnt be an absolute exclusion criteria
 
mmmcdowe said:
This is actually an interesting question that I saw debated amongst several surgical specialties represented by a program director each. Some fields advocated for visual testing as a prerequisite for surgical training. Others were less concerned. The truth of the matter is that it could very well affect your surgical ability. Whether or not this is protected under the americans with disabilities act is unclear because there are limitations. When you apply for residency you sign form attesting that you could physically perform all needed tasks. Some people might interpret binocular vision as absolutely necessary, but I imagine that as a whole it wouldnt be an absolute exclusion criteria
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A number of ENT programs I interviewed at included a task using a surgical microscope as part of the interview day. Apparently, very occasionally, residents leave the specialty after a few years when they realize they have no depth perception and cannot operate using a binocular microscope.

I know plenty of neurosurgery is done under the microscope, so I think a lack of binocular vision would be a big deal. But then again one of my attendings has ridiculous strabismus and there's no way he has binocular vision under the microscope, and he's one of the most technically refined surgeons we have.
 
VisionaryTics said:
A number of ENT programs I interviewed at included a task using a surgical microscope as part of the interview day. Apparently, very occasionally, residents leave the specialty after a few years when they realize they have no depth perception and cannot operate using a binocular microscope.

I know plenty of neurosurgery is done under the microscope, so I think a lack of binocular vision would be a big deal. But then again one of my attendings has ridiculous strabismus and there's no way he has binocular vision under the microscope, and he's one of the most technically refined surgeons we have.
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that must suck so much
 
VisionaryTics said:
A number of ENT programs I interviewed at included a task using a surgical microscope as part of the interview day.
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For some reason these tasks are pretty absent during neurosurgery interviews. I have had many ENT and Ortho friends tell me they are prevalent on their trails. I didn't have a single task like that in any of my interviews and only heard of one program last seasons that did have anything like that. Not sure why they aren't done more in neurosurgery interviews.
 
What would you recommend doing before starting med school to maximize one's chances of getting into a good neurosurgery residency program?
 
tyrsa said:
What would you recommend doing before starting med school to maximize one's chances of getting into a good neurosurgery residency program?
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Get into medical school.
 
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tyrsa said:
What would you recommend doing before starting med school to maximize one's chances of getting into a good neurosurgery residency program?
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I would recommend getting into the highest ranked medical school you can, the prestige and networking opportunities available can make a difference.
 
tyrsa said:
What would you recommend doing before starting med school to maximize one's chances of getting into a good neurosurgery residency program?
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Start doing meaninful research in neurosurgery, ideally at a program that you are interested in for medical school as others have mentioned, but there's a low probability of ending up there for a variety of reasons so I would personally focus on a program where you can do research easily from your undergrad institution's location. Other than that, not much to be done at this point but get into medical school as others have said.
 
I've been working with a neurosurgeon since I was in high school. They really like me there. Try working or shadowing one at a hospital with a residency.

tyrsa said:
What would you recommend doing before starting med school to maximize one's chances of getting into a good neurosurgery residency program?
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mmmcdowe said:
Finishing up pgy2 year. Ama
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Is research really a requirement for all programs, or are there some programs that don't really care that much about research? If all I care about is matching to any program at all, would I able to do it without research? The Charting the Outcomes for 2011 shows that 14/16 applicants with 0 Abstracts, Presentations, or Publications matched, and 11/12 matched in 2014. These numbers suggest that, if one applies and interviews strategically at programs that do not emphasize research, it's not that difficult to match without doing research. Is that a reasonable conclusion?
 
Not all programs but among the research heavy programs it is a very steep uphill battle without it and in general few applicants going to competitive programs are without research because these programs can be choosy even if research isnt their priority. So yes you can match without research but just like applying only to one states programs you are hamstringing yourself in terms of options.
 
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do you ever walk into the OR and say " it's a beautiful day to save lives "
 
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First off I want to thank you for all these extremely helpful posts.
I'm finishing up a post-bacc program in Boston and my last year will be light (with only evening classes). I've been interested in academic neurosurgery for a few years now and would like to get more involved in the field / research (volunteer; have time to research full time).

I'm having difficulty figuring out how to gauge research opportunities.
  1. Is it advantageous to the goal of neurosurgery if I apply to work only in labs run by clinician scientists vs neurobiology PhD working on basic science GBM research who is also neurosurgery faculty.
  2. What kind of research (basic, clinical, etc) and role do you think would allow for a good experience for someone who isn't yet a medical student? For example, the clinical research positions I've seen so far are just being coordinators for the patients involved in clinical studies.
  3. Starting from scratch and working for a year + two summers, what might be a good goals to push towards in terms of training and productivity?
  4. Lastly, what is the best way to contact the labs to start the process. I've emailed a few labs before but have yet to get a response. Do I email the PI/physician? Call the lab manager?
Thank you for your time! I'm lucky enough to have this time and the resources to pursue my dreams so I just wanted to make sure that I maximized the time and opportunities I have now to allow me to be more productive during medical school and in my career.
 
what's your favorite food

ideal pizza toppings?

can you dunk on a 9ft hoop?

i'll think of some more
 
How has PGY2 year been compared to intern year? How many hours per week did you average? What were your toughest weeks in terms of hours worked?
 
Did you get time to work out/lift/etc?
If not interested, did other colleagues who were interested find the time and/or energy for this?
 
I really like surgery but I have found the hospital to not be very enjoyable. I hate rounding and I find following every little lab value and radiograph tedious. I haven't done my surgery rotation so I'm wondering how different it is from IM. How long do the patients on your service usually stay and what percentage of the day in the first few years of residency do you spend managing the floor? I know part of being a good surgeon is taking care of the patients beyond surgery but I just find floor work to be too slow to hold my interest.

Do you think as someone who hated general IM that I would likely also dislike surgery since there is a lot of management involved as well? I am currently in my GI rotation and I enjoy it, we only see like 3-4 consults a day and each one takes like 15 minutes a piece, rest of the time in clinic or doing procedures. If surgery was similar to my GI rotation I would do it in a heartbeat, but from what I've heard it seems like the first 2-3 years of surgery you are very similar to a medical intern without capping restrictions.

I always hear if you love the OR and would not want to be anywhere else you should do surgery. I feel like I love the OR, I just don't love the floor work that goes on in between the OR.
 
First off I want to thank you for all these extremely helpful posts.
I'm finishing up a post-bacc program in Boston and my last year will be light (with only evening classes). I've been interested in academic neurosurgery for a few years now and would like to get more involved in the field / research (volunteer; have time to research full time).

I'm having difficulty figuring out how to gauge research opportunities.
  1. Is it advantageous to the goal of neurosurgery if I apply to work only in labs run by clinician scientists vs neurobiology PhD working on basic science GBM research who is also neurosurgery faculty.
Do what most interests you, presumably a phd in glioblastoma research collaborates with neurosurgeons
  1. What kind of research (basic, clinical, etc) and role do you think would allow for a good experience for someone who isn't yet a medical student? For example, the clinical research positions I've seen so far are just being coordinators for the patients involved in clinical studies.
I thinkb being a coordinator is probably more insightful than benchwork.
  1. Starting from scratch and working for a year + two summers, what might be a good goals to push towards in terms of training and productivity?
Im not sure what you mean by training. As an undergrad I would shoot for at least one first author paper in that time span.
  1. Lastly, what is the best way to contact the labs to start the process. I've emailed a few labs before but have yet to get a response. Do I email the PI/physician? Call the lab manager?
Both are good ideas.

Thank you for your time! I'm lucky enough to have this time and the resources to pursue my dreams so I just wanted to make sure that I maximized the time and opportunities I have now to allow me to be more productive during medical school and in my career.
 
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ZPakEffect said:
How has PGY2 year been compared to intern year? How many hours per week did you average? What were your toughest weeks in terms of hours worked?
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Its variable, both had areas of overlapping difficulty but certainly the hardest block was as the consult resident pgy2. My work week has ranged from 50 to 100
 
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Do you
 
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