.

  • Thread starter Thread starter deleted1095841
  • Start date Start date
This forum made possible through the generous support of SDN members, donors, and sponsors. Thank you.
D

deleted1095841

.
Members don't see this ad.
 
Last edited by a moderator:
Yeah agree with the above. Join your institutional neurosurgery club, usually they work together to publish tons of papers. If you're at a T20, you should be able to get many pubs if you reach out to the right people. Also, get involved in at least one extracurricular that you can take a strong pride in (e.g. starting something in your school, initiate community projects, etc.), it will enhance the "multi-dimensional" aspect in your ERAS app.
 
Members don't see this ad :)
Don't have much more advice to offer than the above posters.

That being said, just focus on being the strongest student you can possibly be. Going into medical school only wanting to match at a Top 10 residency program in an already extremely competitive field is not a healthy mentality. Plus, as you go through medical school you'll come to realize that those rankings are pretty much based off of research output and who-knows-who in the field and don't really have anything to do with the quality of surgical training you receive.
 
Step 2 CK is going to be the new king. So really that means your first two years should be focused on getting at least a 70% on exams, unless you have quartile rankings, then try to be at least in the 2nd quartile. With all this additional time not grinding on preclinical courses, you should use that to research and get pubs. Worry about step 2 ck in third year, as there's really not much you can do now except learn step 1 material well to prep for the clinical years.

And check this out --> Sub-I vs. audition rotation vs. away rotation
 
On top of just being an all around star, if you are targeting a specific program, doing an away and killing it is probably the best way to get their attention. Also getting letters of recommendation from famous people connected to those programs.

But FYI, having 5 programs as a goal is unrealistic so early on in your medical career and is an unhealthy mentality. There is no guarantee they will all even interview you, even with everything perfect on your application. Also why those 5 specifically? There are others that are "ranked" higher than them. I don't mean to get into a pissing battle about program reputation, but just trying to highlight that what is "top" will change both in rankings and for you personally. Keep an open mind moving forward.
 
Become a known commodity. Go to conferences, present research there, publish double digit papers, 265+ Step 2, etc.

Lots of MD/PhDs in those programs, if that really is your goal and you have your heart set on that then maybe consider getting a PhD in medical school.
 
When you're aiming for the top of the top (i.e. one of the most competitive specialties at one of the most competitive institutions within that specialty), what separates you from the next guy is millimeters. You're a 99.4% while the other guy is 99.2%. At that point, once you have done all the prereqs (AOA, pubs, honors, etc), the reason Harvard will choose you versus the next guy I think is quite random. Maybe you and the interviewer were both from the same city, or you got a letter from the interviewer's old medical school colleague, or you smiled just a bit more than the next guy. These are really all things you can't control. Not saying it's impossible to match at Harvard nsgy, but I'm just saying you're competing against the best of the best and the reality is that at that point, it's the principle of diminishing returns, up to the point where luck and randomness play a significant role to where you end up.

The best thing to do is put yourself out there like @AnatomyGrey12 said. I'm sure if you reach out early to Michigan's nsgy department, show your interest at matching at a top institution, maybe the doctors there can introduce you and let's say Harvard's nsgy PD and you can do research together. It's good you're starting now, but just know that even if you do everything in your power, your current goal may lead you disappointed given the fierce competition at the top.
 
lone_cypress said:
Research is something I am intrinsically interested in. But what should the balance between basic science and clinical be?
Click to expand...
Those are very research oriented programs...so I would say ideally you do both. However, basic science is very time consuming and requires long term commitment which can be difficult to do at the same time with clinical and medical school. Clinical research is where you achieve the #. Main thing is get as many first author as you can and work on projects you are interested in and can talk proudly about it during interviews, but don’t pick up more than you can handle. But at those programs, expect at least 15-20 quality pubs.
 
Last edited:
If you want to match into one of those programs in particular, the answer is research, basically to the exclusion of everything else. Step 2CK will be important at some point.

The more important thing you will need to realize is that those are not necessarily the top neurosurgery programs. As you learn more about the specialty your perspective will mature (hopefully before you match). Personally I wouldn't want to train at any of the above.
 
lone_cypress said:
I believe Michigan has quartile rankings. And I also heard they have caps on how many people can get Honors in each clerkship.
Click to expand...

From my understanding, pre-clinical are P/F unranked, clinicals they report quartiles.
 
lone_cypress said:
My dream is to match into Neurosugery at UCSF, Stanford, Harvard (MGH, BWH, etc.), or Johns Hopkins. I know this is hard to attain and not even remotely guaranteed, but I want to take my swing. I am an incoming M1 at a T20 school in the Midwest. What should I do to maximize my chances of getting into one of these residencies?
Click to expand...

Wait you're at a Top 20? The name alone will give you a massive boost. Get in contact with the big names in nsgy ASAP and start churning out many papers and get strong letters. AOA will effectively nearly guarantee top tier match
 
not a fan of Barrow? Like everyone else said, research research research, especially with those schools. Keep your grades up and get to know your home neurosurgery program very well.
 
Members don't see this ad :)
lone_cypress said:
Is there something concerning about these programs I should know about? Since I haven't started medical school yet, my perspective is probably similar to that of a layperson. And which programs would you call "top programs"?
Click to expand...

The issue is, the layman's perspective is often wrong when it comes to "prestige" or "good training" in residency - particularly for surgical fields. The best way for you to get an idea what "top" is, is to speak to actual neurosurgeons throughout medical school. And ultimately, "top" will change for you based on what you will value (location, name, specifics of programs, your research interests) etc. There are probably about 20 academic programs out there that will give you more or less equivalent neurosurgery training. So ultimately, you shouldn't approach this with a layman's understanding and set your goals based on that. Furthermore, the only ranking system we have for residencies is doximity, and while it's okay to get a general understanding of tier, it is by no means an end all be all authority.

I'm sure you're now curious, here are the doximity rankings:

1) UCSF
2) Barrow
3) Hopkins
4) University of Washington
5) MGH - Harvard
6) Columbia
7) Mayo Clinic
8) UPMC
9) WashU
10) Emory
.
14) Michigan
.
16) Stanford
.
18) BWH - Harvard
.
>70) Beth Israel - Harvard

You'll notice, your home program is more "prestigious" than half of the programs you initially listed. These change every year though, and you ask 10 different neurosurgeons, and they will give you 10 different lists.

Regardless, if you want to maximize your chances of matching into a competitive field, you should work hard, make connections, do research, do well on exams etc. That doesn't change. For now, just worry about doing well and establishing good study habits in your first few months of M1. You'll be surprised how easy it is to jump onto research projects at major academic medical centers. Often there are school specific clubs that can hook you up, or professors, or you can simply cold email. But don't do this yet, just enjoy the few months before medical school.
 
Last edited:
lone_cypress said:
Is there something concerning about these programs I should know about? Since I haven't started medical school yet, my perspective is probably similar to that of a layperson. And which programs would you call "top programs"?

I'll be starting at Michigan in the fall. Are there any names you would recommend off the top of you head? Here's the faculty list: Neurosurgery Faculty
It seems to be a relatively small department (only 25 people). I'm also unsure of how to approach them. I'm an MD-only student (not MSTP) so I'm not sure how to convince them to take me on. I have worked at Google for the past 5 years though, so an ability to work with computers and write software is something I can bring to the table.
Click to expand...
Option A: you don’t ask and you’ll never get taken on by them
Option B: you ask to join “just” as an MD candidate, they either say no where you move onto the next PI or they say yes and you just scored a research position.
 
lone_cypress said:
Is there something concerning about these programs I should know about? Since I haven't started medical school yet, my perspective is probably similar to that of a layperson. And which programs would you call "top programs"?

I'll be starting at Michigan in the fall. Are there any names you would recommend off the top of you head? Here's the faculty list: Neurosurgery Faculty
It seems to be a relatively small department (only 25 people). I'm also unsure of how to approach them. I'm an MD-only student (not MSTP) so I'm not sure how to convince them to take me on. I have worked at Google for the past 5 years though, so an ability to work with computers and write software is something I can bring to the table.
Click to expand...
Neurosurgery departments usually aren’t super large.

Not sure about neurosurgery in particular but Michigan surgical programs are usually really highly regarded. It wouldn’t surprise me if UM was more highly regarded than some of the programs you mentioned by people in the field.
 
As an incoming student interested in neurosurgery, the advice I was given was to worry about grades, show my face around my home program (but not too much to the point where you become annoying), and get involved in research. I was also told to try and convince yourself to want to do any other specialty and if you can't do it, neurosurgery might be for you.
 
See how much you like your surgery rotation when you get to your third year of medical school first. See if waking up at 4am for the rest of your life, dealing with perhaps the highest malpractice fees, and committing to a 7 year residency still appeal to you by then.

Aside from that, being a lucky and essentially flawless candidate is probably the only way to obtain one of these residencies. By flawless I mean 265+ step 1 and 2, published research with well known attendings, some major life experience/obstacle, and as many awards, distinctions, and volunteer experiences as possible. Even if all this is met, you probably still stand a less than 25% chance of matching at one of these 4 places due to the immense competition and the fact that nearly everyone who interviews at these programs will have the same resume. Being at a T20 will help though and should make it easier to get publications which will increase your chances both at top programs and at neurosurgery residencies in general. While the training/lifestyle looks pretty miserable, the compensation is enormous and hence the competition. Good luck.
 
Last edited:
How much of neurosurgery's appeal is compensation-based? I wonder if it would be nearly as competitive if it paid like urology or something
 
lone_cypress said:
It's interesting that you mention lifestyle. I'm not familiar with the lifestyle of a neurosurgeon. What is that like?
I'll make it a point to shadow neurosurgeons in medical school as well.
Click to expand...
so you've never shadowed one? I'm curious as to what got you interested in the specialty. Prestige?
 
lone_cypress said:
It's interesting that you mention lifestyle. I'm not familiar with the lifestyle of a neurosurgeon. What is that like?
I'll make it a point to shadow neurosurgeons in medical school as well.
Click to expand...
I'm not going into anything surgical so just going off my clinical experience in medical school.

From my perspective it seemed like very long hours, high stress, and high competition within the speciality (the same goes for any surgical specialty or subspecialty). Though neurosurgery is unique for some reason in having particular high malpractice rates. This may also be tied to the fact that you are more likely to be sued as a neurosurgeon at some point in your career than any other field of medicine (especially spine surgery). While it also comes with a very high amount of prestige and a $500k-1 million salary once you are an attending, you do need to work hard (harder than most other physicians) without as much time to devote to your family/personal life. And of course there is the fact that by the time you are finished with residency/fellowship, you will at least be in your mid 30s assuming there are no gaps at any point in your training.
 
OP you should NOT become JUST a UCSF neurosurgeon. You are selling yourself short 😜😅
 
lone_cypress said:
Good question. I'll admit that:
1. I'm not 100% sure I want to do neurosurgery.
2. My perspective will evolve in medical school (i.e. in clinical rotations and shadowing experiences)

But as for my reasoning, I am very interested in the brain and how it works: How neurons (and of course the glia) interact, electrically and chemically, and how they shape higher-level phenotypes like behavior. And how people can use this understanding to help patients (e.g. deep brain stimulation).

I have shadowed/been around physicians before, but they were in cardiology and emergency medicine (which are very cool by the way, but probably not what I want to do long-term).
Click to expand...
Not really sure this has anything to do with the practice of neurosurgery to be honest. I'm going into a different surgical field though. Maybe @longhaul3 can provide more insight.
 
lone_cypress said:
Is there something concerning about Pitt I should know about?
Click to expand...

Lol Probably not at this stage in your training. Just worry about doing well in school, and finding a few people you connect with, who can also keep you responsible and on task.

The rest will fall into place.
 
lone_cypress said:
Good question. I'll admit that:
1. I'm not 100% sure I want to do neurosurgery.
2. My perspective will evolve in medical school (i.e. in clinical rotations and shadowing experiences)

But as for my reasoning, I am very interested in the brain and how it works: How neurons (and of course the glia) interact, electrically and chemically, and how they shape higher-level phenotypes like behavior. And how people can use this understanding to help patients (e.g. deep brain stimulation).

I have shadowed/been around physicians before, but they were in cardiology and emergency medicine (which are very cool by the way, but probably not what I want to do long-term).
Click to expand...

You haven't really mentioned anything about the surgical aspects of neurosurgery which is kind of the most important thing about it. It sounds like you'd be more interested in neurology
 
jambro said:
How much of neurosurgery's appeal is compensation-based? I wonder if it would be nearly as competitive if it paid like urology or something
Click to expand...
I can't imagine there would be many people who would want to do it just for the money. I feel like Mohs surgeons or plastic surgeons make good enough without having the crazy lifestyle reputation of NS. For me personally, and I know I may end up changing my mind when I get to rotations, my interests in NS come from having shadowed an academic NS. Scrubbing in with her when she did hematoma evacuations were interesting to me. Watching her make burr holes and then exposing the dura and then the brain, excite me; and I know that sounds weird. Lol. Watching her take out tumors excite me. I shadowed this doc once a week for about a year and I never got bored. I found myself getting bored in other specialties that I shadowed after a week. It could be that she only let me scrub in on the cool interesting cases and not the boring bread and butter stuff..idk. However, I loved it. That's not even counting all the fun research you can do with immunology of cancers or deep brain stimulation. Obviously I may end up changing my mind when I start school, or hell, I may find out that my grades won't let me be a NS. It be like that sometimes. lol...but I think most people interested in NS, after having shadowed, actually just like the procedures and not just the income.
 
lone_cypress said:
I see. I had heard a little about this, but it's nice to hear from someone who knows. By long hours, do you mean all-day shifts (like 6am-6pm), or is it even longer than that (like 24hr or night duty). I'm sure there's some night duty as a resident, but I'm curious if that remains after becoming an attending.
Click to expand...
It's probably best to ask someone who is in the field, but in general, it seemed like most attendings I worked with started their day at 6-7am and usually work late into the afternoon/evening often with completely unpredictable schedules. Resident life is even worse and is easily 80+ hours a week. That is on top of all the abuse/hazing you will put up with as a trainee in surgery. My surgery rotation felt like what I would imagine being in the military to be like. General surgery by itself (5 years) looks like the closest thing to hell on Earth I can describe. I can't even imagine what it would be like to have to put in an additional 2 years of training in that environment to become a neurosurgeon.

****Not trying to discourage you from pursuing this field if you are highly interested in it because some people do fit in and thrive with this lifestyle and for all I know you could too. But if you are interested in the brain, there are so many other specialties (neurology, psychiatry, etc) that require you to form a working knowledge in this area, pay well, and don't have quite a strenuous working environment. You really need to to be very interested in surgery for this to be enjoyable field for you. That should come before anything else.
 
Last edited:
OP you have a very immature (immature being not well-formed, not necessarily childish) view of neurosurgery. I encourage you to take a deep explore into your interests. It does not sound like you have any idea what neurosurgery is about much less substantial reasoning behind specific programs.

That said, like you I always had a fascination with the brain. In high school first fell in love with it through studying psychology and biological basis of behaviors. In college I explored all types of career paths to get close to the brain, psychology, Neurobio/neuroscience, etc. I went into medicine for the sole reason of going into neurosurgery. Seriously the only reason I chose MD instead of PhD.

That said, I am applying to neurosurgery this year. Through Med school and additional research years before and during, no other specialty has remotely interest me. That inkling you have that this may be for you very well may be real. Pursue it, but keep your eyes and heart open to all your options.
 
lone_cypress said:
Good point. For me, the thing that makes me interested in neurosurgery as opposed to neurology is the ability to use our understanding of the brain to fix or repair (or at least try to repair) something in the brain to make life better for my patients. I know neurologists can order tests (MRI, CT, etc.) and prescribe medication. Medication can do a lot, but it has its limits. Also in my completely untrained layman's view, it seems imprecise and possibly overkill to flood the whole brain with a chemical to mitigate symptoms that are often due to a problem in just a small part of the brain. I'm a big fan of targeted therapies. I'm really interested in deep brain stimulation, for example, and possibly drug-eluting DBS electrodes. And maybe one day we'll be able to build/cut/rearrange individual synapses to create "more healthy" brain circuitry. The ability to actually "do" things in the brain makes me (naively) interested in neurosurgery.
Click to expand...
I agree with the poster above. You’re view and understanding of what neurosurgery actually is, and what they do on a day to day basis, is pretty superficial and largely incorrect (I mean, a huge portion of neurosurgery is actually spine and not brain).

I suggest getting to school and working to make yourself the most competitive residency applicant you can, and getting exposure to Neurosurgery and also other fields. With what your view is now you have a lot of learning and thought developing to do regarding what field you’re actually going to be interested in.

Who knows, it might just be neurosurgery.
 
Last edited by a moderator:
lone_cypress said:
Thanks for the insight. You're probably right about my view being not well-formed yet.
I'm curious what your thought process was in choosing neurosurgery over other brain-related medical fields like neurology and psychiatry. You mentioned that other specialties weren't very interesting. What about neurosurgery do you find particularly interesting?
Click to expand...

I love neurology as a field. I have met nothing but incredibly talented and intelligent individuals in neurology. My home Neuro department chair definitely tried to persuade me to leave the dark side lol. My college mentor was a neurologist, and my biggest supporter for pursuing neurosurgery. Be open to it if the intellectual stimulation is your greatest motivating factor right now.

I cannot see myself in neurology because I have to be in the OR. I have to be the one doing the surgery. That’s just what it is for me. I cannot see myself in chronic care like movement disorders, post stroke rehab, etc. I did Neuro-critical care sub-internships and specialty neurology rotations and again I was like wow awesome, people are so brilliant and capable but at the end of the day you are rounding and making complex decision yes, but I need to be in the OR.

I will say I am interested in tumor and vascular, yes tumor could arguable be said to be more chronic, but I am in the GBM sphere so very short survivals and critical decision-making in care gives me the feeling of acuity or perhaps a better word would be severity is my pull.

Early on I decided against psychology because of lack of standardization in the field. I found psychiatry to be pretty similar. There are some brilliant minds in psychiatry revolutionizing the field, but still not enough for my interests.

NIR is fascinating, and gives the busy + acute+ serious life/death decisions being made, but when thinking of those other fields (radiology/neurology) to get there you have to consider if I’m not clot busting all day, what am I doing? And am I happy with those bread and butter cases. (Also still takes you 7-9 years to get there because of the 4+4, 4+2+1, etc paths to NIR)

Also side note because I saw your earlier comment asking if NSG work from 6-6pm. I’ll give you a couple anecdotes, I am a student, and even I, in showing my commitment in the field at my home dept have been scrubbed in doing absolutely nothing but retracting in a 16 hour spine surgery on multiple occasions and stayed from 5am to 3am next day because a top of the basilar aneurysm came in at 4 in the afternoon after finishing the first case. This is the type of commitment expected from a student. So yes, neurosurgeons work from 6-6pm and then some on a regular basis. (Leaving at 3am was my chief letting me off early btw they wrapped up at 6/7am)
 
OP you will benefit a lot from reading these two threads. Nothing wrong with asking someone on here who is applying into the field but your more general questions have already been answered many times over, and here are two places where you might find those, as well as answers to questions that hadn't even occurred to you yet.

Ask a neurosurgery resident anything


Finishing up neurosurgery pgy6, ask me anything

lone_cypress said:
I really appreciate you sharing all this! It definitely gives me a better idea. I know that the hours are crazy as a student and resident, but do they become better when you're an attending? Or is it permanent?
Click to expand...
 
In addition to what's been said so far, for neurosurgery in particular, basic science research is important. The top places you mention tend to be super academic and value basic research (although you will need a mix of both in order to put up the numbers of the exceptional neurosurgery applicant).
 
aldol16 said:
In addition to what's been said so far, for neurosurgery in particular, basic science research is important. The top places you mention tend to be super academic and value basic research (although you will need a mix of both in order to put up the numbers of the exceptional neurosurgery applicant).
Click to expand...

Why is there an expectation of basic science research when it takes years of graduate level work to get a high quality basic science paper published? There's literally little to no time in med school unless it's an MSTP
 
VincentAdultman said:
Everyone loves the IDEA of neurosurgery.

What it is in PRACTICE is different. Personally I find it miserable and they couldn’t pay me enough to do it.
Click to expand...

The spine stuff was a huge turnoff for me. I like the stroke and tumor stuff but i'm not going to spend 7 years of painful training to practice what makes up like 20% of nsgy
 
Lawpy said:
The spine stuff was a huge turnoff for me. I like the stroke and tumor stuff but i'm not going to spend 7 years of painful training to practice what makes up like 20% of nsgy
Click to expand...

My recall is that everyone wants to operate on the spine as opposed to the brain because that’s what’s most lucrative. Yeah no thanks.

My hot take is that every MS0-1 thinks Neurosurgery is the first fifteen minutes of the Dr Strange movie where in reality you’re just putting in bolts and shunts all day.
 
VincentAdultman said:
My recall is that everyone wants to operate on the spine as opposed to the brain because that’s what’s most lucrative. Yeah no thanks.

My hot take is that every MS0-1 thinks Neurosurgery is the first fifteen minutes of the Dr Strange movie where in reality you’re just putting in bolts and shunts all day.
Click to expand...

Every time I watch that movie and he breaks sterile practice to put his mask on I yell at the screen.
 
lone_cypress said:
Good question. I'll admit that:
1. I'm not 100% sure I want to do neurosurgery.
2. My perspective will evolve in medical school (i.e. in clinical rotations and shadowing experiences)

But as for my reasoning, I am very interested in the brain and how it works: How neurons (and of course the glia) interact, electrically and chemically, and how they shape higher-level phenotypes like behavior. And how people can use this understanding to help patients (e.g. deep brain stimulation).

I have shadowed/been around physicians before, but they were in cardiology and emergency medicine (which are very cool by the way, but probably not what I want to do long-term).
Click to expand...
This sounds like you'd be interested in neurology more than neurosurgery. Ask to shadow a neurologist.
 
Lawpy said:
Why is there an expectation of basic science research when it takes years of graduate level work to get a high quality basic science paper published? There's literally little to no time in med school unless it's an MSTP
Click to expand...

Even as someone going into the field I still have not found a great answer besides because they can. Plus the top programs are 30-50% MD/PhDs, so there’s that.
 
lone_cypress said:
Which journals are perceived as "high quality" by the academic neurosurgery community?
Click to expand...
You can pull up the google metrics H5-index for neurosurgery and you’ll probably get a decent idea. Won’t be perfect but when looking for the quality of field specific journals it’s pretty good.

This is not including the heavy hitter basic science journals like Cell and Nature, etc.
 
OP - I agree with the above posts on finding out what the field actually entails. I briefly thought of neurosurgery myself while in medical school, but then I quickly figured out - as other posters have mentioned - you are a surgeon first. You have to absolutely love surgery. And...I found out I actually hated the OR.

I have the utmost respect for my neurosurgical colleagues , and - as a stroke fellow- we get to work together for numerous patients. But I absolutely love neurology, and wouldn't trade my specialty for anything.

Whatever you do - don't box yourself so early on in a specific specialty when, to be honest, you really don't know much about it. Keep an open mind as you learn during medical school. What you find you end up enjoying may surprise you.
 
You must log in or register to reply here.
Top