Charting Outcomes 2011 in context

[phenylacetone]

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I'm an MS3 who seems to be something of a late-comer to thinking about neurosurgery.

About me:
-Step 1: 250
-Research - 1 project in undergrad => 1 fourth author publication in chemistry
-AOA - probably not, ~3/15 honors in preclinical, 1 clinical honors so far.
-Mid-tier med school outside top 40
-No other degrees
-No particularly compelling volunteer or work experiences.
-No current connections to PDs or NS mentors.

As such, I'm wandering through my clinical years, keeping an open mind about how I want to spend my career, getting a vague tickle of interest about neurosurgery. My stereotyped med student preconceptions make me think that neurosurgery is only an option for people who knew they wanted to do neurosurgery in middle school. I turned to charting outcomes, and am hoping for some help putting this data into context. I'd ask UncleHarvey, but he won't let me join his forums yet.

People with my step score - 94.9% matched. (people above 251 - 100% matched)
People with my research background - ~70.8-85% matched
People with my grades (non-AOA) - 82.3% matched (with AOA - 100%)
etc.

At the face of it, this raw data leads me to believe I'd have a reasonable chance at matching - perhaps >90%. What's the impression of those of you who know more about this stuff? Is there some self-selection not apparent from a superficial read of the data? If so, what are the factors in play and which matter most?

Also: what are the implications of the 100% match rate above 251 step 1. Does it imply that a relatively unbalanced applicant with stellar Step 1, but otherwise mediocre, is still capable of matching?

 

[spongioform]

I think 2011 was a good year for neurosurgery applicants. If you look at charting outcomes from 2009, 47/53 matched in your category of 241-250, with an additional 7 not matching above 250, definitely worse than in '11 where everyone who scored higher than 250 matched. I think analyzing it strictly from the Step 1 data is misleading, though, as many strong applicants in neurosurgery with strong Step 1 scores correspondingly have pretty solid research/clinical experience in the field. I think it is more likely that the unmatched applicants in the > 240 pool had weak neurosurgery experiences. I also think that matching at a relatively non-name brand program is not as difficult as one may think-perhaps a high step 1 such as yours without a strong research foundation would gain you a spot but would be less likely to gain you a spot at a name brand program unless of course you do a sub-i at such a program and perform well. Also, you have time to get involved in research this upcoming year. Those are just some preliminary thoughts.

 

[kitsunepixie]

Some programs use a certain Step 1 score that the secretaries use to separate applications into ones that will actually make it to the PDs to review from ones that will just go into the trash (harsh, I know). Very important also besides AOA and board scores are recommendation letters from neurosurgeons (I overheard our PD saying, "We have an applicant who looks good on paper but I'm not offering an interview until the rec letters come in..."), grades on clinical rotations (especially Neurosurgery, Surgery, and MEDICINE), and research, especially if it's in neuroscience. I have a few friends who successfully entered neurosurgery after getting a late start in the game who worked hard on Sub-Is and got great rec letters, so I really can't emphasize that enough. How do you really know you want to do NS until you see what it's actually like, anyway? I also know of a couple of >260s who didn't match because of stupid mistakes on their part (acting like DBs on their away rotations mostly, which got around to all the other places across the country where they applied--it's a VERY small world).

 

[phenylacetone]

At this point, it's only a vague, largely unexplored interest. I had the opportunity on inpatient medicine to observe an emergent thoracic corpectomy and fusion on one of my patients with malignant cord compression. It was a powerful experience to admit a patient in the morning and watch their pathology evolve rapidly over the course of hours, then be completely resolved surgically by the next morning. I have no intention to base my career choice on this one experience, but it has stirred the interest. Since neurosurgery is stereotyped as something you have to plan for from day 1, I wanted a second opinion. Fortunately, I honored medicine and might be able to do a 2 week NS rotation at the end of this year. Beyond that, any other specific advice on how to consider getting involved/getting prepared?

 

[jdh19]

I know it's certainly possible to match into neurosurgery after developing an interest later in med school. A person from my institution last year matched after he became interested in neurosurgery mid-way to late in third year. He had no research experience and a 260+ on STEP1.

I'm a fourth year hoping to match this year and from what I've heard on aways is that certain institutions screen applicants on research in a similar manner as STEP score. I don't think it's more than five, but realize there are some programs that will likely not interview you based on that alone. However, there are plenty of others that will. It's also about finding a program that fits you best; it might not be a brand name, but will be perfect for you.

I would encourage you to do a rotation in neurosurgery and then decide if you want to pursue it further. While the spine surgery you saw was surely satisfying, not all outcomes in neurosurgery end up that way. Gliomas in particular can be disappointing. Many neurosurgeons that focus primarily on spine surgery especially microdiscectomies, cervical fusion, etc. do so because dealing with the brain can be as frustrating as it is rewarding. That said, it's a unique field in medicine and worth looking into. Good luck.