Can I apply to 20 programs, or should I add more?

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Latteandaprayer

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I’ll be somewhat specific to get specific advice, but will modify some info.

MS3 at T20 in Midwest. Was in MSTP my first year but decided clinical practice was more for me and dropped the PhD. No bad blood or anything.

Passed all preclinical classes (P/F). Honored all core clerkships except surgery (high pass). (Honored neuro clerkship).

Passed Step 1 first attempt. 260+ on Step 2.

From undergrad I have 2 first-author papers in cell bio. I have been on basically 2 projects in med school. 1 resulted in a poster, and one resulted in a middle author paper. I am currently working on another paper but very early in the process and unlikely to have another pub before ERAS. So 3 pubs, 1 poster.

I am president of the Family Medicine group (long story but wanted FM initially lol, stuck around and became president and I love the work I do).

Not much volunteering. Few hours here and there.

LORs likely average. Asked attendings who liked me and one offered to write the letter without me asking. However, I don’t know the reality of what anyone will write. I’m going to say average because I don’t think anyone will write a bad LOR.

Hoping to stay in Midwest but willing to branch out a bit (my family and fiancé’s family here). I identified about 20 programs I’d be happy at just reading the website and hearsay. Is it a bad idea to apply to 20? How many would you recommend applying to (more, less?)?

I can move this if it’s not appropriate here.

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You are golden for neurology pretty much anywhere as long as you clearly state your interests in neurology in personal statement and interview well (i.e., don't be a jerk or too much of a weirdo during interview). Some may think 20 could be too many when you have such geographic preference for midwest, though in the remote interview age, 20 is a decent number (may need even more for those with some disadvantages such as low board scores, being IMG or DO, etc.).
 
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I'd be willing to bet that you'd be fine with 3 programs with that app, geographic preference, and and obvious regional ties. You'll probably get your #1 unless you interview horribly. Great job on that app.

However, applying to 20 seems perfectly reasonable to ensure against SOAP. SOAPing is a tragedy. Also, in case you change your mind about your preferences.

Forward planning, the only competitive neuro fellowship would be neuro-endovascular or pain. All the typical neuro fellowships are pretty easy to get. So where you go for the next step isn't really that important.
 
Agree with the above. 95% chance you'll have your pick of excellent programs and you could probably apply to 2 or 3 and be just fine.

As a hedge against randomness, apply to 15-20. Make 5 of those dream/reach programs, 10 of those programs you think you'll be competitive for, and 5 safety programs. Based on your responses from applications, pick 8-10 to interview. If you're getting as much attention from good programs as I think you will, you don't really need to waste your time and theirs actually interviewing at the safety programs.

My app was fairly similar to yours but with a lower step 2. I was shocked by how much attention I got in general. I was also a little surprised how rapidly the competitiveness in the specialty increases at the very tippy-top. The programs I thought were my dream programs going into the process weren't what I had imagined, and I was surprised pleasantly by some others. Go with your gut impressions once you've interviewed.
 
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