Definitely could use some advice.

[TUGM]

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[Jambo1]

Hey TUGM,

Im another MS3, about to start my 4th year aways in may. So to answer your original question, while not "competitive" you still definitely can match neurosurgery IMO. The key for you will be to do some SubI's at reasonable places, work hard like you said you can do, and get great letters. Make sure youre the first one in, last one out, always helping etc. Maybe even try to get involved with a research project while on your aways? I would also definitely get in touch with your home program, as having their support will be crucial for your application IMO.

I think another important thing for you though, is to really examine the neurosurgery route. If neurointerventional is your goal, then NSG is overkill IMO to achieve this goal. Before I truly commit to NSG, if I were you I would shadow and see it all and make sure that you like most of nsg, because especially in PP, the vast majority of NSG is spine(discs, lamis, fusions).

Do you have any concrete "deal breaker" type reasons for why you feel its more important to go the NSG route than the neurology route?

 

[starfishprime]

Hey everyone. Long time reader, first time poster. I'm a MS-3 at a midwest program. Thought I wanted to do Neurology for a long time but always loved procedures and surgery discovered Neurointerventional Surgery, and realized that Neurosurgery is my passion.

Unfortunately... I'm not the strongest applicant for Neurosurgery. Honestly - Step 1 was 218/82; probably about 50%-ile class rank, non-AOA, with decent clinical grades. Mostly high pass and sat pass (including General Surgery - ugh), though I did honor pediatric plastic surgery, neurology, and some other not-as-important electives. My evaluations have been pretty flattering, but my shelf exam scores suck a**. No research yet, though I will be getting at least one Neuroradiology/Stroke project in May that will hopefully lead to publication. I'm likable enough and work extremely hard on all my rotations, and my evaluations highlight this. But like I said, Step 1 = blaaarghhhhh.

Still, every day, can't shake the feeling that I should be applying to Neurosurgery instead of Neurology. I know everyone posts, "Do I have a chance?" I essentially have June and July to do out of towns. Though I could be pretty happy in Neurology and would probably gun until I got into neurointerventional, I would much rather sacrifice my life for Neurosurgery.

Any advice? Suggestions? Though I appreciate encouragement, honesty would definitely be preferred! Thank guys!

Neurology and neurosurgery are two of the most polar opposite of all fields. So, first you must decide if it's medicine or surgery for you. Neurology trained neurointerventionalists are very rare creatures; radiologists and neurosurgeons comprise the vast majority.

From a match perspective, you must apply to a less competitive backup specialty somewhat seriously. With your credentials as they are, your chances of matching in neurosurgery are quite small. If you bolster them with research, excellent sub-Is, and great letters, you may improve your chances of matching significantly. However, the greatest nightmare for you is to go completely unmatched, wherein you'd be a below average applicant trying to scramble for reasonably competitive preliminary spots, and you'd stand a very real chance of ending up without any PGY-1 position at all.

 

[TUGM]

Jambo1:

First of all, thanks for the response and support. I will be taking a Neuroradiology/Interventional rotation in May, and Neurosurgery at my home institution in June. As you said, I plan on becoming involved with whatever research is available.

The real "deal-breaker" I suppose is that I inherently can't get over how much I love being in the OR or in the angio suite. Though I love the medicine behind neurological disease as well (which is why I would be happy in Neurology), I love the procedures that treat (some of) these conditions more. I am absolutely in love with endovascular work, though skull-base, stereotactic, minimally-invasive/transnasal, and even spine turn me on quite a bit too... haha.

 

[TUGM]

starfishprime:

What you pointed out is pretty much my greatest fear. I feel that, in this day and time, there is a lot more collaboration between Neurology, Radiology, and Neurosurgery. Neurology-trained interventionalists are definitely a rarity, as you said, but I am starting to see several of them around who are very successful. I get the feeling that these guys are the exception, though... they are exceptional interventional surgeons!

Also, I figure if I end up not matching (YIKES!), I'd try to SOAP into radiology or neurology... seemed to have been several unfilled spots. *Nervous LOL*

 

[fishsnack]

DO NOT rely on the SOAP for anything. I have some friends who went through it unsuccessfully. You absolutely have to apply to a back up specialty. The best you can realistically hope for is a prelim surgery spot, which is terrible.

The annoying thing about applying to both NS and neuro or rads is that you have to interview for prelim spots too, which is a hassle.

People do match with low step 1 scores, but you need to show some dedication.

 

[pooh86]

The annoying thing about applying to both NS and neuro or rads is that you have to interview for prelim spots too, which is a hassle.

I know someone that applied to two specialties, one of which required prelim. He/she interviewed for all three and was able to get it done. But BOY, was it exhausting...just prepare yourself.