DO, bottom of my class. Chances for Neuro residency?

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browncatman

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Hi All,

I'm an M2 now, I just got my class rank and am bottom 5% at a DO school. I'm really trying to figure out how my future looks. I've wanted to do Neuro for years and looked into it a lot but don't have any research.

Here is some interesting info:

We took a test on logical reasoning at the beginning of school. I scored in the top 1% of my med school class. I've gotten perfect or near perfect on every logic or math test I've ever taken.
I studied 60-80 hours a week through M1 year, but don't have any noticeable test anxiety. I really couldn't have studied any harder.
I wasn't a science major. I did the bare minimum prereqs.
I had an MCAT that would have gotten me above the average at most MD schools, but barely a 3.0 GPA.
I should do better on boards than my class rank would predict but I can't imagine crushing them.
I think I have ADHD and have been diagnosed by a few people, I take meds just about daily but don't really like being on them. I wouldn't really want to be on them post medical school or really post residency.
All my pt contact and everything has been great, people generally seem to like me and I feel good at that part. I've been good at diagnosis or the more reasoning type stuff in general.

So I guess

A. What the heck is going on here?
B. How does Neurology look for me?
C. How does completing a residency period and becoming a functional doctor look?

Plz don't quote this incase I want to delete it later.

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Here are some of my observations:

The big name "top" programs and scenic locations (Cali, NYC, New England in general, Miami, Chicago + WashU, Mayo, CCF, UTSW) in Neurology are pretty hard to get into. Being a DO is going to make things worse. It's not necessarily fair, but MDs are given preference over DOs. This will make things a bit harder for you.

No PD will really look at any parts of your application prior to medical school. From what I have been told, your numbers and actions during your time in medical school is what you will be judged on. This being said, the most important number will be Step 1, then maybe Step 2, and maybe GPA. GPA shouldn't be too important. However, red flags, such as failures in any standardized examinations or classes will be looked at. If you get interviews, they WILL ask you about it. Your response during these times is critical.

What you should focus on is doing well on Steps, doing some audition rotations and making an EXCELLENT impression, getting involved in Neurology-related activities, and getting stellar LORs. If you can bolster these quintessential parts of your application, you shouldn't have very much trouble matching.

As far as your ADHD - my roommate and buddy from medical school had pretty significant symptoms and also hated taking his medication because he would never sleep or be hungry, so I can understand how that can be frustrating. There are different formulations of pharmacotherapy that can be implemented for better control, but this is something that you should definitely discuss with your physician. Sometimes, we find ourselves very good at reasoning, problem solving, and thinking outside the box. At the end of the day, however, there are some things that you just have to sit down and learn cold, especially in medicine. For example, you need to know the guidelines and core measures when diagnosing, admitting, treating, and discharging stroke patients. Doesn't take much reasoning or thinking outside the box. Localization of lesions is a different matter, but when it comes to that, from what you say about yourself, you should have no trouble.
 
The best advice I can give you is not to stress. Everything you did your first 2 years of med school doesn't really matter as long as you passed. Your performance for the first two years carries as much weight as one month long clinical rotation your 3rd year. No one will look at your college GPA when you apply for residency. Your Step 1 and 2 scores carry a lot of weight, so the best thing you can do for yourself is rock one or both of those tests.

Some people are better at the books and others are much better on wards - the two don't necessarily correlate. The fact that you are good at logic tests is great because it (somewhat) implies you have a lot of common sense. This is one of the most important qualities to have to keep people from dying when they're under your care. The major factors when trying to match are step scores, performance on ward months (especially neuro and IM), and letters of rec (preferably from a well known neurologist). Research experience is also helpful but not necessary.
 
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