Reapplicant: Should I give up on neurosurgery?

[Levrone]

Hi. I'm a US MD grad who soaped into a prelim year after not matching neurosurgery. I had 4 interviews and applied broadly.

Stats: Step 1: 250 Step2: 245 Clinical Grades: Mix of pass and high pass (I was told this was going to be the reason I had trouble matching). I think I can also definitely improve my personal statement, but I'm not sure that will help much anyway.

My research also would be considered below average for neurosurgery. I only have a few published papers and research experiences, nothing major. My school didn't have a home nsg program and I had a lot of trouble finding a mentor. Either way, here I am now, planning to apply to neurology with nsg as a backup. I know I want to do neurosurgery, I just don't know what I can do to make it happen. I was thinking possibly a research year next year after finding some faculty to accept me, but I'm just not sure right now. Spending an additional year and still not matching would really be disheartening. But I also don't want to go into another field and not be happy.

I have heard a few success stories of people applying 3+ times before ultimately matching neurosurgery, and honestly that's given me hope. I'm just not sure what to do, as applications to reapply are going to be due soon.

Any guidance would be great. Thank you.

---

Members don't see this ad.

 

[FindersFee5]

Hi. I'm a US MD grad who soaped into a prelim year after not matching neurosurgery. I had 4 interviews and applied broadly.

Stats: Step 1: 250 Step2: 245 Clinical Grades: Mix of pass and high pass (I was told this was going to be the reason I had trouble matching). I think I can also definitely improve my personal statement, but I'm not sure that will help much anyway.

My research also would be considered below average for neurosurgery. I only have a few published papers and research experiences, nothing major. My school didn't have a home nsg program and I had a lot of trouble finding a mentor. Either way, here I am now, planning to apply to neurology with nsg as a backup. I know I want to do neurosurgery, I just don't know what I can do to make it happen. I was thinking possibly a research year next year after finding some faculty to accept me, but I'm just not sure right now. Spending an additional year and still not matching would really be disheartening. But I also don't want to go into another field and not be happy.

I have heard a few success stories of people applying 3+ times before ultimately matching neurosurgery, and honestly that's given me hope. I'm just not sure what to do, as applications to reapply are going to be due soon.

Any guidance would be great. Thank you.

Have you done anything to improve your application since last year? More research? Closer relationships with neurosurgery faculty members? If not, your chances of matching this year are going to be even worse than last year. Your prelim year does not count as a positive.

 

[GoSpursGo]

Yeah I basically echo what others have said, you need to have something concrete that you can point to for why you are likely to be successful this year when you weren't last year. If you cannot identify concrete improvements (meaning new publications, new letters, new connections--not subjective things like your personal statement), then I think you should expect the same result.

 

[deleted50541]

Have you been in the neurosurgery forum? You might get some better advice there.

Sounds like the limited research and lack of strong faculty support probably hurt you the first time. Did you make any good connections with NSG faculty at your current institution to get new LORs? Having new research projects lined up would also be a boon for your application.

On a positive, looking at the match numbers, NSG does have a slightly higher match compared to other surgical programs (85% last year) with 11 MD grads (not MD seniors) getting spots. The 2021 match did look a bit tougher compared to the last four years too. So, there is a chance. But you've got to have something new to offer. If you don't frankly, then programs that get your application again may not even consider you if nothing has changed other than your prelim year.

Lastly, you really have to ask yourself if NSG is what you want to do. Do you truly understand the sacrifice it takes to spend 7+ years in training?

 

[longhaul3]

The same application has a lower chance of matching as time goes on. You need to improve your application more than this rate of decay, usually with research. With your good step score it may be salvageable with a ton of research, like a research year with some big-name, chairman-type PI.

The other thing is that you really have to love neurosurgery to put yourself through all this. Even for people who breeze through med school and the match, it's brutal in a way that nobody outside of neurosurgery can understand. It is by far the hardest and most grueling specialty in medicine. To take at least 2 years trying to match after a non-match with a low chance of success only to stare down the beginning of neurosurgery residency sounds unpalatable to me. If I had been in your shoes and not matched, I would have changed course for sure. Hell, there were times early on in residency that I thought about bailing.

Lastly, it's pretty unusual for someone to be interested in both neurology and neurosurgery this late in the game. Neuro is one of the very last fields I would ever go into. We are not like-minded, and neurology types would not do well at all in neurosurgery. I've met a bunch of neurology residents and attendings who were at some point considering or had pursued neurosurgery (including having had some amount of neurosurgical training), and I hate to be harsh but frankly I would not want any of them to be my colleagues.

If you've already not matched and can see yourself liking neurology, you should just do it, or find something more in line with neurology like radiology or medicine. What aspects of neurosurgery make you feel like you wouldn't be happy doing something else?

 

[droliver]

It is by far the hardest and most grueling specialty in medicine.

Not by a long shot. They work hard to be sure, but General Surgery residents work harder and take care of the sickest patients on a regular basis.

 

[longhaul3]

Not by a long shot. They work hard to be sure, but General Surgery residents work harder and take care of the sickest patients on a regular basis.

I disagree with you, but I'm not interested in debating that point or trying to convince anyone. I respect the general surgeons the most out of all of our colleagues and enjoy working with them.

 

[Matthew9Thirtyfive]

Keep the thread on topic please. Discussing who has the most grueling training is not it.

 

[operaman]

I think you’ve answered your question. Your app is basically the same as last year which after broad application and 4 Is yielded no match. Odds are good that happens again. There’s probably not much to lose beyond application fees if you reapply along with a backup.

Have you reached out to Neurosurg faculty where you are now? Was your prelim able to give you a Neurosurg elective? Our prelims were always given some elective time in their preferred field to help get more letters and reapply.

 

[getfat]

It seems like you're pretty adamant about neurosurgery. I would atleast throw in a couple apps to select programs that you either interviewed at or your maybe someone you know is rotating there. The neurosurg forum would be better help than us.

I would focus on a back up plan (wiether its neuro or general surgery) something that atleast gives you a career so you aren't the bitter attending that thinks he should've been a neurosurgeon.

 

[Levrone]

Sorry about not replying earlier. I came from a med school without a home nsg program, and SOAPed into a prelim program without a home nsg progrm as well, so I haven't been able to make any connections in the field and am unsure of where to even find research at this point. I'm worried I won't be happy in neurology, but thats the only other field I currently have LOR's in, and applications are now due in like 20 days. I'm pretty sure I don't want to do gen surg though.

 

[Deltasidearm]

Take Step 3 and spend another year to get more research under your belt before applying again. One more year won't be much in the long run and it doesn't seem like you've done anything in this past year to improve the deficits you identified in your previous application.

 

[Levrone]

I've talked to 1 chairman and one PD nsg who didn't think research would help :/, but I've seen the general consensus on this board is that research years are helpful and one of the few ways to actually improve your application. agh I really am unsure of what to do. I don't want to have taken 2 years off to do research only to get 2-3 interviews and go unmatched again when I could have already been an attending. :/

 

[collegestud2013]

I've talked to 1 chairman and one PD nsg who didn't think research would help :/, but I've seen the general consensus on this board is that research years are helpful and one of the few ways to actually improve your application. agh I really am unsure of what to do. I don't want to have taken 2 years off to do research only to get 2-3 interviews and go unmatched again when I could have already been an attending. :/

If that's the impression you're getting from Neurosurgery PD and Chairs I would move on and do something else as the additional research has uncertain value in helping you match. Since you applied broadly the first time and got only 4 interviews suggests the issue is primarily with your application (as opposed to someone only applying to a small number of programs and not matching). Unless you have significant connections in the field (eg family member or close family friend is a Neurosurgery PD) the chances of matching don't sound high.

 

[operaman]

I've talked to 1 chairman and one PD nsg who didn't think research would help :/, but I've seen the general consensus on this board is that research years are helpful and one of the few ways to actually improve your application. agh I really am unsure of what to do. I don't want to have taken 2 years off to do research only to get 2-3 interviews and go unmatched again when I could have already been an attending. :/

Sounds like you’ve gotten your answer. The lack of honors grades clinically is definitely a ding. Neurosurg is typically brutal especially on interns and juniors. I remember watching the Neurosurg intern just getting crushed every day and having to shoulder a lot more responsibility than any of the other PGY1s. It’s overwhelming even for strong students, so it may be that the clinical grades are holding you back.

Research years are helpful, though honestly it’s often more about the connections and potential to match where you do your research than it is about a few more stripes on the CV.

Again, maybe worth tossing a few apps in just in case this year isn’t as competitive as last year, but definitely have a solid backup option.

 

[GoSpursGo]

Sorry about not replying earlier. I came from a med school without a home nsg program, and SOAPed into a prelim program without a home nsg progrm as well, so I haven't been able to make any connections in the field and am unsure of where to even find research at this point. I'm worried I won't be happy in neurology, but thats the only other field I currently have LOR's in, and applications are now due in like 20 days. I'm pretty sure I don't want to do gen surg though.

Look, just to echo what others have said, it really doesn't seem like this is going to happen. You need someone to vouch for you, and without a home program from your school or from your current location, I am not sure who that is going to be. You have no new research and are a year out from med school. If anything, your app is going to be weaker than last year. Research years are given to applicants who the chairman/PD believes would make a good resident, so if they aren't willing to consider you for a research year that tells you that they aren't interested either.

Send a few targeted apps if it makes you feel better. But at the end of the day, sometimes you have to accept that not everyone gets to work in their desired specialty.

 

[Lawpy]

I've talked to 1 chairman and one PD nsg who didn't think research would help :/, but I've seen the general consensus on this board is that research years are helpful and one of the few ways to actually improve your application. agh I really am unsure of what to do. I don't want to have taken 2 years off to do research only to get 2-3 interviews and go unmatched again when I could have already been an attending. :/

Ouch that's a big downer from the PD/chairman

Honestly OP, going neuro is the best bet

 

[FutureSurgical]

Is there nothing else you could see yourself doing? Try applying DR/IR perhaps? Get into ESIR if you don't match IR and then subspecialize in neuro IR. It's minimally-invasive and isn't the same. But that's what I can come up with as a lowly M2.

I'm really sorry this is happening to you OP. I pray you'll match into neurosurgery if you apply this cycle

 

[longhaul3]

The honest answers from the PD/chairman are valuable. They did you a favor by not leading you on. Especially if two different people said the same thing, I would take that answer and move on as quickly as possible so you can get your career started without wasting your hard work and more years of your life.

 

[deleted849476]

In addition to all the other helpful advice here, OP, once a month call every NSG program that you interviewed at and ask if their intern quit yet. Its just another way to show your commitment if even for next cycle and hey, if you’re there and they liked you enough to interview you originally and now they need someone who is passionate, you might just be able to snag a pgy1 spot. It happens and I personally know a NSG (I think chief now?) resident who got in this way.

And this is the lame advice, but a GS PD once told me, don’t think of anything as your “backup”. Meaning, you want NSG now, yes, but don’t fool yourself that you couldn’t be happy in something else. I say shoot for NSG as many times as you are up to it, and the last time you roll the dice also rank a reasonable backup specialty and perhaps be prepared to SOAP primary care or something and just discover a new passion.

And then if you do get into NSG, dont forget to go back to your med school’s surgery club and say “Yea I just couldn’t imagine doing anything but NSG in fact at the time I didn’t even know other specialties existed haha GS is so gross”

 

[Radgy]

Blessing in disguise? Just putting a plug in for radiology as interventional Neuroradiology is always a possibility if you shall choose. Or you eventually (likely) realize how freaking cool diagnostic radiology is and your future life thanks you for it.

 

[Lost in Translation]

Going to speak from experience: chances are you will not Match into Neurosurgery coming out of a prelim year.

Source: personally know 5 very strong NSGY-hopefuls who did a Gen Surg Prelim program with a home NSGY program at that institution. None matched the second time around.