Neurosurgery still possible?

[neurowizard22]

I took step 1 this past summer and I received a score of 219. This was significantly lower than what I was expecting, given that my last few practice test scores were in the 230s. As you can imagine, I was quite devastated. I really want to do neurosurgery, and after completing my neurosurgery elective and general surgery rotation, I am still just as determined. I have some research in neurology (stroke) and I'm working on my paper for that right now. But I do not have neurosurgery -specific research. I plan to take Step 2 as soon as year 3 is over so I can have my score ready for residency.

My question is that with my step 1 score, is it still possible to get into a neurosurgery residency? I've heard that many programs have cut-offs, below which they will not even consider an application. I plan to do some neurosurgery research, and I have a meeting set up with my neurosurgery program director to discuss my situation. But I would love to have some insight from someone who is familiar with neurosurgery programs. I just hope it's not too late to do something about this.

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[Phloston]

If your Step 1 holds you back, then you could easily perform well in a prelim year somewhere, get good recs, do some research, and yeah, you'd match.

 

[mmmcdowe]

Yeah, I would say that doing a prelim year in another specialty is never an easy path to getting into a neurosurgery residency. It is a huge red flag even if you did somehow manage to distinguish yourself. Your best bet is to rock clinical year, step 2, your subis, and take a year off to score mad pubs.

 

[DonutShot]

I second this advice. Your ability to match drops exponentially after each year you apply and do not obtain a spot regardless of what you do in the intervening years. Your best chance is your first chance. Having said that, it isn't impossible matching with that score since it is just one part of many data points used to evaluate applicants but you need to excel in other areas to bring something to the table to make programs want you to train with them as well as alleviate their concerns of your ability to pass the neurosurgery boards or ability to safely make clinical decisions. Remember, all programs, especially smaller programs (1/yr) really want to mitigate risk. If you get fired or leave it screws over your co-residents hard since the call pool etc. is shared by such a small number of individuals. Furthermore, many programs have strict step 1 screens that regardless of how outstanding your application is, unless you have a personal connection to the program or a mentor has a strong connection then the program will never even see your application for consideration for an interview.

Sounds like you are on the right track though. Focus on the things you have control over now and just grind. If this is something you really want to do it will show. Make sure you are well prepared applying for and selecting programs for aways and residency applications.

Yeah, I would say that doing a prelim year in another specialty is never an easy path to getting into a neurosurgery residency. It is a huge red flag even if you did somehow manage to distinguish yourself. Your best bet is to rock clinical year, step 2, your subis, and take a year off to score mad pubs.

 

[MohnishKodali]

Yeah, The residency training program is comprised of three general stages structured into a seven-year curriculum. The first stage, the PGY-1, PGY-2, and PGY-3 years, is comprised of a period of a junior residency status that includes sets of neurosurgery and neurosurgery-related rotations. The second stage is a two year Research/Scholarship experience that may include traditional bench-lab research work, clinical or translational research, or enhance subspecialty neurosurgical clinical skills in an infolded-fellowship. The third stage is composed of two years of senior/chief resident rotations which complete the training period in all manner of complex neurosurgical technique and prepare the resident for independent neurosurgical practice. This graded approach to training provides progressive increase in skills and responsibility until the resident is ready to become an independent fully trained neurosurgeon.

 

[addy]

Mohnish Kodali, you're just embarrassing yourself, homie.

 

[meer]

Is it possible for an img with scores : step 1 (236) , step 2 ck (229) and step 2 cs (passed 1st attempt), no USCE, no research........... to get matched in neurosurgery. ?

 

[Yoyomama88]

Is it possible for an img with scores : step 1 (236) , step 2 ck (229) and step 2 cs (passed 1st attempt), no USCE, no research........... to get matched in neurosurgery. ?

hmm, i think unlikely. Your step 2 doesn't help you and the lack of research. Now if you had a ton of research and good connections, I would argue you would have a shot.

 

[mmmcdowe]

Is it possible for an img with scores : step 1 (236) , step 2 ck (229) and step 2 cs (passed 1st attempt), no USCE, no research........... to get matched in neurosurgery. ?

Probably should take a year or two to do research to maximize your chances.

 

[green222]

So... 241 Step 1 and will have 1-2 submitted for publication articles and 1 poster presentations. Grades mostly honors, not AOA. What are my chances of matching to a mid tier program?

 

[mmmcdowe]

So... 241 Step 1 and will have 1-2 submitted for publication articles and 1 poster presentations. Grades mostly honors, not AOA. What are my chances of matching to a mid tier program?

If you aren't crazy good

 

[tiedyeddog]

So... 241 Step 1 and will have 1-2 submitted for publication articles and 1 poster presentations. Grades mostly honors, not AOA. What are my chances of matching to a mid tier program?

My step 1 was almost exactly yours, that number won't get you screened out of too many places. At least 1 aways, try for 2. Get good letters from home and your aways and just be a normal person. You should have decent odds if you do what I just said.

 

[BrainPains]

Yeah, The residency training program is comprised of three general stages structured into a seven-year curriculum. The first stage, the PGY-1, PGY-2, and PGY-3 years, is comprised of a period of a junior residency status that includes sets of neurosurgery and neurosurgery-related rotations. The second stage is a two year Research/Scholarship experience that may include traditional bench-lab research work, clinical or translational research, or enhance subspecialty neurosurgical clinical skills in an infolded-fellowship. The third stage is composed of two years of senior/chief resident rotations which complete the training period in all manner of complex neurosurgical technique and prepare the resident for independent neurosurgical practice. This graded approach to training provides progressive increase in skills and responsibility until the resident is ready to become an independent fully trained neurosurgeon.

Someone is good with that cut n' paste
https://surgery.uchicago.edu/specialties/neurosurgery/education/residency/

 

[Harvey260]

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[Bombrainiac]

Everyone, I can assure you that Step 1 scores are heavily weighted in the neurosurgery application process (and other specialties weigh this score a lot as well). It is the easiest, most straightforward way for a bunch of time-crunched surgeons to assess an applicants discipline and focus. Now, this doesn't mean that a great Step 1 score is the only thing assessed or that this score is even being used appropriately, but you've GOT to think about the people who are reviewing your application. That should make it pretty easy to understand the importance of your board scores. This is not a secret in the neurosurgery application world, but we also understand that many medical schools give their students protected months (sometimes up to 6 whole months) off just to study and score well on the USMLE Step 1, while other medical schools do absolutely nothing to give their students time to study. This makes it unfair, but at the same time, you, as a student, have to think ahead and plan accordingly. It used to be that scores of 260 or better were pretty rare events; now, it is actually very common, if not, the norm to see all applicants with scores of 250 or better.

The Step 1 is one part of your application. It does not make up for shortcomings elsewhere and it will not get you into a neurosurgery residency program. If, however, your application is strong, but your Step 1 score is NOT, then eyebrows will be raised since it will be viewed as an inconsistency. It doesn't makes sense that you would have great research, great letters, great grades, strong extracurriculars, great everything else, and a subpar Step 1 score unless you just had an off day or are a bad standardized test taker. Those exceptions are viewed as such, and will be obvious when reviewing your whole application.

One thing I can tell you for sure: your letters of recommendation are THE MOST IMPORTANT PART OF YOUR APPLICATION. These can literally make or break your application regardless of anything else and its the part of the application that the reviewers spend the most time reading and discussing. Neurosurgery is a small world. The right (or wrong) letter from the right person goes a LONG way.