help!!!

[jayhawk]

I'm a second year interested in Neuro and do not know much about how to score a residency. I am not looking to match at a super competitive school, but just would like to know the basics...what kind of Step 1 do I need? GPA? What schools are good for neuro(especially dimentia and alzheimers)? I've already started getting to know some of the staff by showing up for neuro clinics. Any advice would be fabulous!

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[mpp]

The match results for this year and last are as follows:

current year / previous year
# registered 1010/1067
IMG registration 548/579
Matched 503/487

# US Seniors matched 317/313
# US Grads matched 8/32
# IMG's matched 138/140

Had list - no match 176/153

Avg USMLE Matched 218/216
Avg USMLE no match 200/198
# Matched w/ PhD 52/not available

Rank lists US appl 334/324
Rank lists others 305/314

Avg applications 19.3/18.4
Avg interviews 6.2/6.0

% Matching total 79%/76%
% US Seniors matched 95%/97%
% US grads matched 50%/80%
% IMG's matched 48%/51%

As far as interest in Alzheimer's, you can first take a look at residency programs that are attached to NIH Alzheimer's Disease Centers (a list is available here). Hospitals that are known for good neurology departments include the ones on the U.S. News Hospital ranks (link) so you can check if there are residency programs attached to these hospitals (although not all of them are academic centers). Also, just check with the neurology department at your school. I'm sure they'd be more than happy to know you are interested in their field and happy to tell you the way to look for good programs that will fit with your goals. Good luck!

 

[mpp]

I forgot to add that you might want to look at residency programs that have fellowships in behavioral neurology or similar as they would probably be good places to train someone interested in alzheimer's even though you may not end up going on through fellowship training.

 

[panch]

hey jayhawk,

it's not that hard to match adult neurology, esp as a us senior. as far as gpa: i dunno as my school doesn't keep them. but things like AOA, MD/PhD, and/or publications (esp in the neurosciences) will definitely help. as you can see from mpp's post, the average board score for step 1 for matched us senior was 218 this match, which is right around the mean.

also, check out your SIGN group at your med school (if you have one, if not then start one). if you're at U K then contact Dr. Slevin, if you're at U Louisville it's Dr. Remmel.

check out these websites:
http://aan.com/students/medical/index.cfm
http://www.aneuroa.org/residents-fellows/menu.shtml

you're doing the right thing by getting to know neuro attendings at your school early on, esp by shadowing/going to clinic. that will help you in at least three ways: 1. actually see what neurologists do; 2. having the neuro attendings get to know you (just think how it will be when you ask for letters, they'll have known you for much more than just your rotation during 3rd/4th year); 3. getting a leg up and clinical correlation early so that when you hit the floors you'll be ahead of the game.

i'd also recommend studying your bum off for step 1, good scores will always help and may even get you an interview call at a few places that love to preen about how high their average board scores are for their incoming residents... (more than a few of the "top ten places").

also, see if you can't write a review or work on a research project w/ a neuro attending (esp if they've been invited to write a review, b/c then you're much more likely to get published). remember: this is not necessary to match neuro, but it won't hurt.

try to do one or two away electives early in your fourth year (neuro is early match) so that you can get at least one letter from a well-known attending at a big department.

my naive, biased, and incomplete list of centers of dementia/behavioral (i haven't started residency yet, but i am quite interested in dementia/behavioral neurology):
Wash U (excellent and prolly the premier clinical Alzheimer's research center, the ppl there are soooo nice and friendly; awesome functional imaging)
Mayo (see above, also more broad into behavioral)
UCSF (a building program and potential to be the top behavioral)
UCLA (a behavioral mecca in the US, awesome imaging)
U Penn (quite strong in Cognitive and Behavioral, great imaging)
Baylor (another mecca for Alzheimers, esp basic sci)
Partners [MGH/BWH] (behavioral and alzheimers, awesome imaging)
BIDMC (more cognitive, will be building as build funding strength)
Columbia (well regarded dementia, esp minority populations)

i dunno bout Hopkins or Emory (didn't read up on them yet)

so this is not fair, above are most of the top recognized programs in the country...

also check out:
U Mich - Ann Arbor (strong in neurodegenerative dis)
U Pittsburg (?)
U Florida
Northwestern U
Cleveland Clinic - Florida (also will prolly recruit a big name basic sci/clinical dementia researcher w/in the next year)

link to AAN website for fellowship search (note: this is not a complete list either as one can often apply to work directly w/ individual attendings):
http://aan.com/students/awards/fellowship.cfm

good luck

 

[jayhawk]

thanks for all of your advice. it is really nice to have unbiased, friendly advice. you guys are great!

 

[dcw135]

In behavioral neuro its less where than who. And it very much depends on what you want your fellowship to concentrate on: neuro behavioral syndromes, cognitive research, or dementia - basic reserach or epidemiology.

Do if your interested in neuro behavioral/research, in no order:
- Heilman and many others, Gainesville Fl - probably the top place for behavioral neurology in the country.
- Damasio, Iowa - leader in the field
- Ramachandran and many others, San Diego - get the most NIH funding for neurosciences of any institution. Tons of monkey studies (Renyolds). Also very strong in dementias (Thal).
- Pascal-Leone and Galaburda, BI - former is on forefront of TMS, latter on dyslexia, huge history, ie, Geschwind.

There are many other people who are huge in the field, but those are some highlights from what I've seen.

I know less about the dementias, but the strongest places I've consistently heard: NIH in basic science, Columbia for epidemiology, Atlanta for all degenerative diseases especially cog of movement disorders. And you can get clinical training anywhere, then go open up the AChEI-of-your-choice-who-will-buy-your-house-and-put-your-kid-through-Andover-then-Harvard clinic and wait for the next greatest anti-amyloid pill to try.

For now, concentrate on the next step - getting through med school. You can go anywhere from any residency because behavioral isn't competitive (but you can go anywhere from any residency in EMG if you're quality in neuro anyway), so relax. Have to go.

 

[dkn79]

hey panch,

congrats on matching at harvard

i'm a first year med student, i was wondering...how important is it that i honor my preclinical classes?

also, where are good places do away rotations (i'm in chicago)

Any advice would be helpful

 

[panch]

thanks for the congrats dkn79

again i, defer to dcw135 (i intentionally didn't mention names in the last post, but for my money Dr. Morris at Wash U or Dr. Peterson at Mayo are the people that i want to be if i go into Alzheimers, Dr. Cummings at UCLA or Dr. Miller at UCSF if i go Behavioral)

re honors preclinical: don't get yourself worked up about it. i say this from personal experience, my first year and the beginning of my second i was so stressed about getting honors in every class that i ended up making myself pretty unhappy and wound up too tightly. sure it helps, but if you focus on honors you're going to forget why you're in med school in the first place (trite but true). work your ass off, do your best, have fun, and you'll shine in your own way. plus, as you'll see and hear here and most other places, clinical grades matter more than preclinical (esp in your field of choice)

about away rotations: depends on where you want to be and what school you're from. if you're focusing on chicago for your residency in adult neurology, i'd go to Rush (warning, the away rotation scheduling system was a mess when i tried last year, hoepfully better this year) or northwestern. if i had my druthers and wanted to stay in chicago, i would want to be at rush or nwu.

if you want to stay in the midwest but are a bit mobile, go to wash u (an amazing place for neurology, a few different options for away electives: neuro-icu, gen neuro, dementia), mayo (another amazing place for neuro), or ann arbor. cleveland clinic seems to have a good thing going as well, and i've heard great things about the teaching at Indiana U

if you're aiming for weather and an excellent program: baylor, ucla, emory, ucsf.

decent enough weather (i guess), excellent program: hopkins.

if you're willing to live in chicago type weather: boston (HMS system: bidmc, the brigham, mass gen), u penn, columbia, u rochester.
(p.s. i have an especially positive opinion of u penn and would highly recommend it as an awesome place to be for neuro)

note: in chicago i think that u of chicago will become more attractive for residents as they'll have five adult neuro residents starting PGY2 this july (and in the years to come?), and hopefully they recruit more faculty that are actually interested in teaching their residents. their biggest hang-ups for me were these two issues.

i would strongly advise you to do an away if you can fit it into your schedule. try to show them that you're smart and a hard worker and get a letter for your apps (even if you don't get a letter for apps cause it's too late, you'll still have an ally at the school (see the comments by "afmsboy" in the IM thread discussing away electives).

if i were in your shoes as an m1 and intending on academic or academic/private neuro, i would get involved in research and/or writing a review this summer)

above all, have fun. neurology is a challenging field and will be as enjoyable and interesting as you make it. check it out by shadowing a few attendings in different settings (academic, private, subspecialty, peds neuro).

cheers,
panch