Neurology residency chances/advice

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Basically the title. Third year medical student at a newish DO school in the mid-south. Will be applying neurology for the 2025 cycle.

Third quartile class rank
7/8 honors on clinical rotations. (HP on our OMM rotation)
Step 1 and COMLEX 1: Passed both on first attempt
Step 2: 230
COMLEX 2: 525
No research
Virtually no volunteer work
I assume my personal statement is your average run of the mill personal statement. Nothing too exciting or overly challenging in my journey to medicine/neurology.
3 Neuro letters and 1 IM letter. Again, had great rapport with all 4 of these docs and would assume they would be strong, but you never know.
Glowing reviews in my rotation feedback from attendings.
Student member of the American Academy of Neurology. Attended a handful of talks during this years conference virtually.
Involved with the Neuro-Pysch club and the Radiology club at my school. No leadership position held though.
White male who went from high school to college to medical school with no gaps. No real working experience expect for some research in college.
Will not be doing any aways/Sub Is. Just don't have the money quite frankly. But, will be doing 2 months of neuro later this summer at my core rotation site.
No failures or repeats during medical school. No criminal history. No red flags.

Wanting to apply to the south/midwest. Think all the states that border the Mississippi river + southeast. Really don't want to go to the west or northeast.
Would love to match at big academic center with fellowships, but would not be against matching community. Not 100% sure if I would do a fellowship anyway.

Went to medical school thinking IM to fellowship. Fell in love with Neuro during preclinical. Confirmed that by doing an elective during early third year. Enjoy neuro hospitalist and neuro crit care more than outpatient so far.

So, what are my chances? Any tips, tricks, advice. How many places should I apply? How to crush interviews? Is my dream of becoming a Neurologist likely to become a reality?

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[s5260205]

You look good on paper, and you will match assuming you apply to a reasonable number of programs (with decent spread between "reach" and "safety" programs). You did well on rotations, so interviewing well should not be a big hurdle either.

Coming from DO school puts you in disadvantage in two ways other than "DO bias". First, there is often no neurology residency or department affiliated with your school/hospital, meaning often the neurology LoR would come from non-academic neurologists which may not carry as much weight as those affiliated with neurology residency and may even be well known in their respective subspecialty. Second, MD students have access to research more easily through their core neurology rotations in third year, and research in some forms would be ideal in the more academic-oriented programs (think name brand programs such as Vanderbilt, Emory, Duke in Southeast) as these programs' ideal fit are those who will pursue academic careers.

I would not shy away from sending applications to these programs though, just keeping in mind that they want more research-minded students and matching at a less academically-oriented program in no way makes you a lesser neurologist (you will be well trained no matter where you go as there is a lot of self learning involved, and there are good and bad neurologists from every program even "top" ones).

I should add that most neurology residency programs are academic just to varying degree (there are university-affiliated programs but not many physician scientists, and majority of faculty are more educators and not doing as much "ground-breaking" research). If research is not your interest, I would still encourage finding a program with some representations from each subspecialty, as this will broaden your fellowship choices. Many people change their mind from heavily inpatient subspecialty such as stroke, NIR, NCC during residency as they get exposure to more exciting fields such as movement disorders, epilepsy, and neuromuscular (I am biased). It would therefore be prudent to work with these subspecialists first before writing off outpatient-focused subspecialties completely.