I'm starting to show an interest in Neurosurgery, but I'm at a loss at what to do

[shadowlightfox]

Before I address my main issue, I'm aware that there are past topics about this, but the core focus of them are too out of place. Additionally, most of the people who created those topics already have more established credentials than I do back when they brought up the subject, so their issues may not be as applicable to me.

Regarding my issue. I'm at a loss of what to do. I'm starting to show interest in neurosurgery after going through couple of events that fostered my interest in it, but as you all are already aware, upon doing some research about the requirements it's already a very steep uphill battle as a DO student. According to some old topics some ACGME residencies don't even look at DOs.

It's especially steeper for me because I have no publication to back myself on compared to other people having the same desires. I'm just like all the other average students in that regard. I do not have any publication under my name. Had I known earlier in my life prior to coming to medical school that I might seriously be considering this field, I would have definitely sought out opportunities to further enhance my road to neurosurgery before becoming a medical student. But unfortunately, it's after I enrolled in medical school that my interest towards it is immensely building up.

My question is: Should I give up pursuing this because I'm already "past my prime" no matter how genuinely interested in the profession I may be? I'm currently researching some neurological research that exist, but I'm not sure if at this point in summer it's too late. Plus there's the issue of competing with other people who have already done way more work than I have, etc.

Regarding if I have the drive, I have what it takes to handle demanding situations, and I am not afraid to bust my butt to get my work done. Obviously all this is contingent upon meeting other requirements, like killing the boards, rotations, etc.

Is there anyone here who realized they wanted to pursue neurosurgery, or any other demanding competitive specialty only after they became a medical student with no extraordinary background that would like to chime in?

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[Drrrrrr. Celty]

Decide whether to give up when you get your step 1 score.

Likewise if you do break the scale with your score you can always take a year off and do research.

 

[shadowlightfox]

Decide whether to give up when you get your step 1 score.

Likewise if you do break the scale with your score you can always take a year off and do research.

That's another issue. Because, like I mentioned in my other post, it's highly highly competitive as a DO, taking a year off to do research only to not get the residency will make it all seem like a waste. It would feel like a huge gamble.

Not that I won't do it, of course, should I be presented with the option. But that lingering concern is still there.

 

[Drrrrrr. Celty]

That's another issue. Because, like I mentioned in my other post, it's highly highly competitive as a DO, taking a year off to do research only to not get the residency will make it all seem like a waste. It would feel like a huge gamble.

Not that I won't do it, of course, should I be presented with the option. But that lingering concern is still there.

I think it's reasonable to have concerns. I think that you should aim high and try. If you fail you can end up in a closely related field like neuro or gs.

 

[navigator]

That's another issue. Because, like I mentioned in my other post, it's highly highly competitive as a DO, taking a year off to do research only to not get the residency will make it all seem like a waste. It would feel like a huge gamble.

Not that I won't do it, of course, should I be presented with the option. But that lingering concern is still there.

I don't think you'd have issues matching or at least getting interviews if you get a solid Step score, actually take a year off for research, and are productive during that year and publish! It's been done before. Contact the incoming NS resident at Mayo Jax for tips if you wish. He's a great guy and very interested in helping people out!

 

[SurgeDO]

What year are you, OP?

 

[Blunt Dissection]

As a DO student that is interested in Plastics, I know how you feel about the uphill battle. This weekend I looked at every single Plastics program in the country that had their list of current residents and currently, there are only 2 DOs - both of them are fellows. Like every other ultra-competitive specialty, being DO means you need to go beyond what is expected. If the average board score for NSG is a 245, you should be shooting for scores in the 250s at the minimum. During rotations, you have to live by the mantra of "arrive early, leave late." There will continue to be a bias against DOs in these ultra-competitive fields for awhile and as an applicant, it'll be up to your numbers, letters, and research experiences that'll make them look past that bias.

Edit - I'll add to this though that you should know this challenge and also have a "back-up." I don't know enough about NSG, but with Plastics, if you don't match integrated, there's the option to try and shoot for the fellowship so when the time comes I'll be applying both.

 

[gyngyn]

In the last five years, 7 DO applicants have matched ACGME neurosurgery: http://www.nrmp.org/wp-content/uploads/2017/06/Main-Match-Results-and-Data-2017.pdf
See page 31.

We don't know how many applied.

 

[IslandStyle808]

In the last five years, 7 DO applicants have matched ACGME neurosurgery: http://www.nrmp.org/wp-content/uploads/2017/06/Main-Match-Results-and-Data-2017.pdf
See page 31.

We don't know how many applied.

On this page go under the ACGME Residency and select neurological surgery (it should appear as a pdf/document). However, I don't know if shows just DOs applying only to the ACGME or DOs that applied to both AOA and ACGME (meaning the data includes DOs that withdrew)?

ERAS Statistics - ERAS - Services - AAMC

 

[gyngyn]

On this page go under the ACGME Residency and select neurological surgery (it should appear as a pdf/document). However, I don't know if shows just DOs applying only to the ACGME or DOs that applied to both AOA and ACGME (meaning the data includes DOs that withdrew)?

ERAS Statistics - ERAS - Services - AAMC

If we put the two sources together for the most recent year where data is provided for the number of applicants, there were 37 ACGME applicants from DO schools in 2015 and no matches.

 

[IslandStyle808]

If we put the two sources together for the most recent year where data is provided for the number of applicants, there were 37 ACGME applicants from DO schools in 2015 and no matches.

This is true. The only issue is knowing who amongst the group were applying AOA and had to withdraw when they had a AOA spot. This would then give a more accurate number. When 2020 comes around, the data will more accurately show a DO's chances in general.

 

[shadowlightfox]

What year are you, OP?

I finished first year.

 

[shadowlightfox]

This is true. The only issue is knowing who amongst the group were applying AOA and had to withdraw when they had a AOA spot. This would then give a more accurate number. When 2020 comes around, the data will more accurately show a DO's chances in general.

Interesting, because 2020 is the year I graduate (assuming I don't take a year off in research). So my class will be the first class to have to deal with the merger.

 

[AnatomyGrey12]

This is true. The only issue is knowing who amongst the group were applying AOA and had to withdraw when they had a AOA spot. This would then give a more accurate number. When 2020 comes around, the data will more accurately show a DO's chances in general.

It also includes people who may have not gotten any interviews at all, just anyone that used the ERAS application system. I really wish we had the numbers even for these competitive fields, included if they had a USMLE score and what the averages were of those who did have one. As it currently stands we only have fairly useless data, anecdotal evidence, and the traditional beliefs to guide applications into the competitive fields.

 

[IslandStyle808]

Interesting, because 2020 is the year I graduate (assuming I don't take a year off in research). So my class will be the first class to have to deal with the merger.

Same with myself. Hopefully most of the neurosurg. programs do transition before that point (I know they have to already have sent their applications in). The fields I'm aim interested are not that competitive so I won't worry too much about former AOA programs.

 

[Ioannes Paulus]

Wait until you get your step1/level1 score back, then make the decision.

 

[IslandStyle808]

It also includes people who may have not gotten any interviews at all, just anyone that used the ERAS application system. I really wish we had the numbers even for these competitive fields, included if they had a USMLE score and what the averages were of those who did have one. As it currently stands we only have fairly useless data, anecdotal evidence, and the traditional beliefs to guide applications into the competitive fields.

I'm face palming when I look at people who send in only half the amount of applications to these hyper competitive fields that their MD counterparts are doing. I understand that they might be applying to other similar fields (thus increasing the amount of place they are applying to). However, they should applying to these fields like a Carribbean grad. applies to radiology. They should be sending far more application than our US MD counter parts.

 

[Blunt Dissection]

It also includes people who may have not gotten any interviews at all, just anyone that used the ERAS application system. I really wish we had the numbers even for these competitive fields, included if they had a USMLE score and what the averages were of those who did have one. As it currently stands we only have fairly useless data, anecdotal evidence, and the traditional beliefs to guide applications into the competitive fields.

I find it a little interesting that the NRMP PD survey from last year shows that a good number of PDs surveyed won't even consider a COMLEX score in fields like NSG/Plastics/Derm and such. Regardless of the merger or not, I think with the way the Match is setup, there's no great way for PDs to make decisions without relying on board scores that they're familiar with. I'd imagine for PDs that have been used to seeing MD applicants for most of their careers, a 600 COMLEX doesn't mean as much as a 250 USMLE. Every D.O student interested in these subspecialties should realize that when they apply to these specialties, they're competing against the creme de la creme of allopathic students. It blows my mind when there are students at my school saying they're very serious about matching Ortho when they're getting 225s on their NBMEs.

 

[IslandStyle808]

I find it a little interesting that the NRMP PD survey from last year shows that a good number of PDs surveyed won't even consider a COMLEX score in fields like NSG/Plastics/Derm and such. Regardless of the merger or not, I think with the way the Match is setup, there's no great way for PDs to make decisions without relying on board scores that they're familiar with. I'd imagine for PDs that have been used to seeing MD applicants for most of their careers, a 600 COMLEX doesn't mean as much as a 250 USMLE. Every D.O student interested in these subspecialties should realize that when they apply to these specialties, they're competing against the creme de la creme of allopathic students. It blows my mind when there are students at my school saying they're very serious about matching Ortho when they're getting 225s on their NBMEs.

There is a DO bias, but another large part of the problem of poor matching is the horrible understanding of application process and their competitiveness as DOs. You got DOs who try to aim for competitive field with scores less than 240 of the USMLE. You got DOs who also apply to such field and send around <30 applicants when their MD counter parts are sending 60. You got DOs who come into these field with almost zero research or even research that is not even in the field of interests. You got DOs who had really terrible advice or none at all given to them by their school.

For these competitive field, even if PDs had an understand of the COMLEX, they would still need to have a USMLE score due to the sheer amount of MDs applying to their programs.

 

[Blunt Dissection]

There is a DO bias, but another large part of the problem of poor matching is the horrible understanding of application process and their competitiveness as DOs. You got DOs who try to aim for competitive field with scores less than 240 of the USMLE. You got DOs who also apply to such field and send around <30 applicants when their MD counter parts are sending 60. You got DOs who come into these field with almost zero research or even research that is not even in the field of interests. You got DOs who had really terrible advice or none at all given to them by their school.

For these competitive field, even if PDs had an understand of the COMLEX, they would still need to have a USMLE score due to the sheer amount of MDs applying to their programs.

That right there is a big big big big thing that I've noticed not only at my own school, but at several DO schools. Everything that I've found in terms of information on matching, residency, competitiveness I've had to find on my own either through SDN, specialty websites, or physicians in the field. From what I understand, part of the reason why it's not discussed is because it induces stress and anxiety and administration opts to let students do their own research at their own pace. This is perfectly fine for those interested in mild to moderately competitive specialties, but it doesn't work for ultra-competitive specialties because by the time people look into it, they're already behind the 8-Ball. Using NSG as an example since this is what OP is interested in, someone that is certain about wanting to be a neurosurgeon and knows what is expected in terms of competitiveness before they even start MS1 has a huge advantage over those that are figuring it out after MS1. In the span of 1st year these people are able to get involved with research, make important connections, and do it in a relaxed manner compared to those trying to figure it out during MS2.

 

[SurgeDO]

I finished first year.

I'm a DO who matched neurosurgery.

You're not too late. I didn't have any publications and matched my #1. As a DO, you gotta hustle everyday for a spot in neurosurgery. You can't just have an interest in the field; you gotta want it with every fiber of your being.

Feel free to PM me if you have any questions.

 

[AnatomyGrey12]

I'm a DO who matched neurosurgery.

You're not too late. I didn't have any publications and matched my #1. As a DO, you gotta hustle everyday for a spot in neurosurgery. You can't just have an interest in the field; you gotta want it with every fiber of your being.

Feel free to PM me if you have any questions.

I think I speak for all of the incoming MS1s that are interested in competitive specialties when I say thank you for your posting contributions over the years. You are a great help and inspiration.

 

[shadowlightfox]

I gotta echo what the other two posts above me said. Congrats, and I really do appreciate all the advice I'm seeing here.

And yeah. I might eventually throw you a PM to ask more about the road ahead.

 

[shadowlightfox]

This is perfectly fine for those interested in mild to moderately competitive specialties, but it doesn't work for ultra-competitive specialties because by the time people look into it, they're already behind the 8-Ball. Using NSG as an example since this is what OP is interested in, someone that is certain about wanting to be a neurosurgeon and knows what is expected in terms of competitiveness before they even start MS1 has a huge advantage over those that are figuring it out after MS1.

Exactly. I'm glad you understand my predicament.

 

[Mr Roboto]

I'm a DO who matched neurosurgery.

You're not too late. I didn't have any publications and matched my #1. As a DO, you gotta hustle everyday for a spot in neurosurgery. You can't just have an interest in the field; you gotta want it with every fiber of your being.

Feel free to PM me if you have any questions.

I'm interested in a less competitive field, but am really curious how much not having any publications affected your app, and what you did to overcome that.

 

[ortnakas]

I finished first year.

Thinking ahead is always a good idea, but you're panicking a bit early on this one. I don't think you're in crisis mode quit yet-- that's the people who fall in love with a competitive specialty in the middle of third year with a not-superstar boards score. It's summer, so at the moment focus on sleeping, Netflix and margaritas. Then focus on getting good grades next year and rocking Step/Level 1. Keep an eye out for research opportunities second and third year.

 

[SurgeDO]

I'm interested in a less competitive field, but am really curious how much not having any publications affected your app, and what you did to overcome that.

I definitely stood out. It was definitely a deficiency within my application. It seemed like the overwhelming majority of applicants had multiple papers published, and I definitely had to explain myself at interviews. I'd definitely recommend getting some publications.

I think I was able to overcome it with good LoRs and board scores. My mentor called the PD at the program I matched at and really vouched for me. I felt like I had a good interview at the program as well. I also like to think of myself as a down-to-earth, normal person, which goes a very long way in the surgical subspecialties.

 

[W19]

I'm a DO who matched neurosurgery.

You're not too late. I didn't have any publications and matched my #1. As a DO, you gotta hustle everyday for a spot in neurosurgery. You can't just have an interest in the field; you gotta want it with every fiber of your being.

Feel free to PM me if you have any questions.

Did you match at an ACGME program? Remember OP will be 'confronted' with the merger... It won't be easy for DO who are gunning for these top specialties.

Someone in my class (MD) has taken a year off to do research at NIH so he can be competitive for neuro and his step1 is in the 240s. The competitiveness of some these specialties are up there!


Have a gen surgery as a back up plan OP!

 

[Mad Jack]

I think it's reasonable to have concerns. I think that you should aim high and try. If you fail you can end up in a closely related field like neuro or gs.

Or ortho spine, which is less competitive overall for DOs than NS.

 

[Mr Roboto]

I definitely stood out. It was definitely a deficiency within my application. It seemed like the overwhelming majority of applicants had multiple papers published, and I definitely had to explain myself at interviews. I'd definitely recommend getting some publications.

I think I was able to overcome it with good LoRs and board scores. My mentor called the PD at the program I matched at and really vouched for me. I felt like I had a good interview at the program as well. I also like to think of myself as a down-to-earth, normal person, which goes a very long way in the surgical subspecialties.

Did he do that for multiple places you ranked? If that place hadn't ranked you highly would you be concerned about not matching? I'm sorry, not trying to cast shade on your impressive achievement, just trying to understand how this whole process works...

 

[IslandStyle808]

Did he do that for multiple places you ranked? If that place hadn't ranked you highly would you be concerned about not matching? I'm sorry, not trying to cast shade on your impressive achievement, just trying to understand how this whole process works...

This is what DO faculty members should be doing. I see multiple of stories of MD PDs or faculty calling residencies and vouching for their students. Instead DO schools leave us students high and dry.

 

[Moose A Moose]

Worried about risk?

OP, anyone who wants a specialty like NS badly enough is willing to put their neck down on the chopping block. Way of the land, bae.

 

[SurgeDO]

Did he do that for multiple places you ranked? If that place hadn't ranked you highly would you be concerned about not matching? I'm sorry, not trying to cast shade on your impressive achievement, just trying to understand how this whole process works...

My #1 was a program that I was gunning for since my first year of medical school. In terms of my rank list, it was significantly ahead of my #2. My mentor knew this, and he also knew the attendings at the program I matched at. From my knowledge, it was the only place he called and put a good word in for me.

Had he not put a good word in, I think I probably still would have matched. Like I said, I was hustling for a spot at my program since first year of medical school. I had good board scores. I had good LORs from big names.

I'm not trying to brag; just trying to paint a picture of a typical surgical subspecialty applicant. Although I matched my #1, I definitely would say that there were many more applicants who were much more competitive than I was.

Did you match at an ACGME program? Remember OP will be 'confronted' with the merger... It won't be easy for DO who are gunning for these top specialties.

Someone in my class (MD) has taken a year off to do research at NIH so he can be competitive for neuro and his step1 is in the 240s. The competitiveness of some these specialties are up there!


Have a gen surgery as a back up plan OP!

For anonymity's sake, I'm gonna plead the fifth on this one. My situation is somewhat unique, and I'd like to remain somewhat anonymous in order to provide the best advice I can to medical students. I will say that I have experience with both AOA and ACGME programs, and my advice applies to both. The applicants I met who are now in AOA programs were insanely competitive. I'm talking COMLEX scores in the 800s. Research was important in both the AOA programs and ACGME programs. Probably a little bit moreso in the ACGME programs. With that said, I was still able to match without any pubs.

 

[AnatomyGrey12]

My #1 was a program that I was gunning for since my first year of medical school. In terms of my rank list, it was significantly ahead of my #2. My mentor knew this, and he also knew the attendings at the program I matched at. From my knowledge, it was the only place he called and put a good word in for me.

Had he not put a good word in, I think I probably still would have matched. Like I said, I was hustling for a spot at my program since first year of medical school. I had good board scores. I had good LORs from big names.

I'm not trying to brag; just trying to paint a picture of a typical surgical subspecialty applicant. Although I matched my #1, I definitely would say that there were many more applicants who were much more competitive than I was.



For anonymity's sake, I'm gonna plead the fifth on this one. My situation is somewhat unique, and I'd like to remain somewhat anonymous in order to provide the best advice I can to medical students. I will say that I have experience with both AOA and ACGME programs, and my advice applies to both. The applicants I met who are now in AOA programs were insanely competitive. I'm talking COMLEX scores in the 800s. Research was important in both the AOA programs and ACGME programs. Probably a little bit moreso in the ACGME programs. With that said, I was still able to match without any pubs.

For surgical subspecialties what type of board score should you be aiming for from day 1 to get to the point that the boards won't be what holds you back?

 

[SurgeDO]

For surgical subspecialties what type of board score should you be aiming for from day 1 to get to the point that the boards won't be what holds you back?

This is a good question that I don't have the exact answer to.

it's important to have good board scores, but personally, I think any board score (or any red flag in an application) can be overcome if another part of your application is strong enough to make up for it. I met some applicants this year who had sub-average neurosurgery board scores that made up for it by being published in several big name journals. Some applicants on the AOA side had subpar board scores but had awesome auditions that made up for it.

I didn't hear of any ACGME programs that had minimal step 1 score requirements. I only heard of one AOA program that had a minimal level 1 requirement of 600 to be interviewed. Honestly though, I don't think that number screened a lot of the applicants out.

I'm going to be pretty ridiculous and say that you should shoot for a 650+ and 250+ on COMLEX and USMLE, respectively. This would be a good goal and probably a little too idealistic of a blanket statement. I don't think this is your golden ticket or a requirement to ride the surgical subspecialty train, but I do think these are some numbers to aim for that will set you up nicely when it comes time to apply. I know people who matched with scores less than this, and I know of people who didn't match with scores greater than this.

 

[Mr Roboto]

My #1 was a program that I was gunning for since my first year of medical school. In terms of my rank list, it was significantly ahead of my #2. My mentor knew this, and he also knew the attendings at the program I matched at. From my knowledge, it was the only place he called and put a good word in for me.

Had he not put a good word in, I think I probably still would have matched. Like I said, I was hustling for a spot at my program since first year of medical school. I had good board scores. I had good LORs from big names.

I'm not trying to brag; just trying to paint a picture of a typical surgical subspecialty applicant. Although I matched my #1, I definitely would say that there were many more applicants who were much more competitive than I was.

For anonymity's sake, I'm gonna plead the fifth on this one. My situation is somewhat unique, and I'd like to remain somewhat anonymous in order to provide the best advice I can to medical students. I will say that I have experience with both AOA and ACGME programs, and my advice applies to both. The applicants I met who are now in AOA programs were insanely competitive. I'm talking COMLEX scores in the 800s. Research was important in both the AOA programs and ACGME programs. Probably a little bit moreso in the ACGME programs. With that said, I was still able to match without any pubs.

Definitely not interpreting it as bragging, thank you very much for the explanation! It's important for us to develop a realistic understanding of what is required to match in competitive fields.

 

[AnatomyGrey12]

This is a good question that I don't have the exact answer to.

it's important to have good board scores, but personally, I think any board score (or any red flag in an application) can be overcome if another part of your application is strong enough to make up for it. I met some applicants this year who had sub-average neurosurgery board scores that made up for it by being published in several big name journals. Some applicants on the AOA side had subpar board scores but had awesome auditions that made up for it.

I didn't hear of any ACGME programs that had minimal step 1 score requirements. I only heard of one AOA program that had a minimal level 1 requirement of 600 to be interviewed. Honestly though, I don't think that number screened a lot of the applicants out.

I'm going to be pretty ridiculous and say that you should shoot for a 650+ and 250+ on COMLEX and USMLE, respectively. This would be a good goal and probably a little too idealistic of a blanket statement. I don't think this is your golden ticket or a requirement to ride the surgical subspecialty train, but I do think these are some numbers to aim for that will set you up nicely when it comes time to apply. I know people who matched with scores less than this, and I know of people who didn't match with scores greater than this.

If you have time would you be willing to do a review of all the DO neurosurgery programs?