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DO student looking at surgical subspecialties, can someone give some insight?

asa0009

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Hi everyone,

I'm a DO student. I recently did a masters that is basically 2/3 of first year medical school and am starting into MS1 so I will have some "spare" time and I need to know what I should be working on. I know I still have a LONG time to go but I'm interested in some surgical subspecialties including neurosurgery and the integrated cardiothoracic surgery programs. I knew that these programs were extremely competitive as is but now I'm extremely concerned due to the fact they are NOT DO friendly. I've done my research and out of over 100 neurosurgery programs only 21 programs have a DO resident (usually only 1 out of the 6-12 spots considering they only take 1-2 residents per year). These are also including AOA programs that have made the merger like Carilion where their entire program is DOs. I believe only 3 or 4 made the merger. In the integrated cardiothoracic programs, I only found 3 programs that had a DO resident. I also know you can take the independent pathway of general surgery + 2-3 years cardiothoracic surgery fellowship but clearly the integrated pathway is a lot more appealing due to less years clearly. I'm a great student, however I'm concerned since my year will be the year step 1 goes pass/fail. I'm good at networking and very extroverted so I'm not worried about being likable, I'm worried about not having the other key parts of the application.

If anyone has some insight on what programs might be looking at as more important in the future due to step 1 being pass/fail please let me know. I know I need to decide on one or the other because neurosurgery you need to start working on research and getting publications basically yesterday and need to start networking in both of these regardless. Anyone who has matched in either of these have any advice? I prefer neurosurgery but the pathway to cardiothoracic surgery can be reached through general surgery which I have much higher chances at matching at where there is no general surgery to neurosurgery pathway. Either which way I would be happy with either because I love both just preference of neuro.
 

Gen3ricDO

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There was one DO who matched CT surgery in the past 3 years. He had significant experience as a scrub tech working with ct surgeons. Very unlikely for any other person to expect to repeat that. Also, there were only 3 DO NSGY matches this year. I matched ortho and the recommendations for that I’m sure apply to neurosurgery, but on steroids. You’ll need to crush whatever boards programs will see. You’ll need to do away rotations at every DO friendly or historical AOA neurosurgery residency that is left and be the person everyone loves. You in all honesty, will probably need a highly productive research year.
 
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asa0009

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Thanks for your response! I worked as an EKG tech for 2 years but that doesn't necessarily help any since I was more in contact with cardiology fellows and not any of the surgeons. I plan on doing as many away rotations as possible and starting into surgery specific research this year. I'm currently working on a non-surgery related publication, so that also doesn't help my chances much but it is research. I know ortho is also research heavy depending on the program, did you elect to take a full research year between 3rd and 4th year?
 
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Gen3ricDO

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Thanks for your response! I worked as an EKG tech for 2 years but that doesn't necessarily help any since I was more in contact with cardiology fellows and not any of the surgeons. I plan on doing as many away rotations as possible and starting into surgery specific research this year. I'm currently working on a non-surgery related publication, so that also doesn't help my chances much but it is research. I know ortho is also research heavy depending on the program, did you elect to take a full research year between 3rd and 4th year?

No I only had 3 publications, but DO ortho programs don’t care too much for research. If I was trying for MD ortho, then I would’ve Considered a full research year. Neurosurgery will require a full research year as all of your competition will be doing one, and neurosurgery really values research output. CT surg is such a reach, you’ll almost certainly have to go the general surgery route first if your heart desires that field.
 
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AnatomyGrey12

Neurosurgery is easily the hardest field for a DO to land. Now that the DO programs are merged I fully expect there to be less than 5 DO's match it on a yearly basis, and those that do are true rockstars. It's one of those fields where you can literally have a perfect app and still not match. You will need to slaughter Step 2 and, as mentioned above, will likely need a highly productive research year with a residency program.

I6 CT is also extremely competitive and not really a realistic goal for most DO students. Honestly I would fully be ready to do the GS -> CT route as a DO, although I6 does happen every so often as seen with the poster mentioned above. I think there are DO's at UC Davis in I6 CT as well.
 
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asa0009

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Neurosurgery is easily the hardest field for a DO to land. Now that the DO programs are merged I fully expect there to be less than 5 DO's match it on a yearly basis, and those that do are true rockstars. It's one of those fields where you can literally have a perfect app and still not match. You will need to slaughter Step 2 and, as mentioned above, will likely need a highly productive research year with a residency program.

I6 CT is also extremely competitive and not really a realistic goal for most DO students. Honestly I would fully be ready to do the GS -> CT route as a DO, although I6 does happen every so often as seen with the poster mentioned above. I think there are DO's at UC Davis in I6 CT as well.
Thank you for the brutal honesty. Definitely a lot to take into consideration. I do think if I were to go the CT route I will definitely need to shoot for it through GS.
No I only had 3 publications, but DO ortho programs don’t care too much for research. If I was trying for MD ortho, then I would’ve Considered a full research year. Neurosurgery will require a full research year as all of your competition will be doing one, and neurosurgery really values research output. CT surg is such a reach, you’ll almost certainly have to go the general surgery route first if your heart desires that field.
I understand that ortho actually has to do the spine surgeries, how close are you with the neurosurgery team when working on things like that?
 

Gen3ricDO

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Thank you for the brutal honesty. Definitely a lot to take into consideration. I do think if I were to go the CT route I will definitely need to shoot for it through GS.

I understand that ortho actually has to do the spine surgeries, how close are you with the neurosurgery team when working on things like that?

We rotate with ortho spine doctors not neurosurgery. Most of the procedures are identical. PLIF, ACDF etc. we just don’t do anything with the brain. I’ve been with an ortho doc that reduced dislocated facets on a patients cervical spine. Was very cool.
 

DarkHorizon

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We rotate with ortho spine doctors not neurosurgery. Most of the procedures are identical. PLIF, ACDF etc. we just don’t do anything with the brain. I’ve been with an ortho doc that reduced dislocated facets on a patients cervical spine. Was very cool.

Very high pucker factor. I made it all the way to PGY4 without seeing one then had two in one night. One made it with no neurologic compromise, the other with quadriplegia.
 
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longhaul3

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If you think you're interested in neurosurgery as a DO you should be making plans ASAP for a research year between 3rd and 4th years. Find a solid program that has a good reputation and good research output, but one that you will have a chance to match at (i.e. not UCSF or another place that will never take a DO). Work your tail off, make connections, and go on every interview you get.

I understand that ortho actually has to do the spine surgeries, how close are you with the neurosurgery team when working on things like that?
Spine is a much bigger part of neurosurgery than ortho. Last I heard, around 70% of cases performed in the US by neurosurgeons are spine cases.
 
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asa0009

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If you think you're interested in neurosurgery as a DO you should be making plans ASAP for a research year between 3rd and 4th years. Find a solid program that has a good reputation and good research output, but one that you will have a chance to match at (i.e. not UCSF or another place that will never take a DO). Work your tail off, make connections, and go on every interview you get.
Thanks for this advice. Is there a specific way you should go about this, like an application, or do you contact faculty at the institution letting them know you’d like to do a research year and see if there’s any interest in one of them kind of mentoring you there to make connections?
 

Gen3ricDO

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If you think you're interested in neurosurgery as a DO you should be making plans ASAP for a research year between 3rd and 4th years. Find a solid program that has a good reputation and good research output, but one that you will have a chance to match at (i.e. not UCSF or another place that will never take a DO). Work your tail off, make connections, and go on every interview you get.


Spine is a much bigger part of neurosurgery than ortho. Last I heard, around 70% of cases performed in the US by neurosurgeons are spine cases.

To me, those numbers just mean neurosurgery does more spine in their own practice. I.E. general neurosurgeons all do spine, but general orthopedic surgeons don’t. Comparing a neurosurgeon to an ortho spine surgeon, however, you would probably see similar numbers of spine surgery performed on a weekly basis. There are probably more spine surgeries performed by the ortho guys because they don’t do anything with the brain.

If 70% of neurosurgery is spine anyway, maybe OP should consider ortho spine?

Not like that’s super easy either, but ortho is at least a little easier to get than neurosurgery as a DO.
 
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asa0009

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To me, those numbers just mean neurosurgery does more spine in their own practice. I.E. general neurosurgeons all do spine, but general orthopedic surgeons don’t. Comparing a neurosurgeon to an ortho spine surgeon, however, you would probably see similar numbers of spine surgery performed on a weekly basis. There are probably more spine surgeries performed by the ortho guys because they don’t do anything with the brain.

If 70% of neurosurgery is spine anyway, maybe OP should consider ortho spine?

Not like that’s super easy either, but ortho is at least a little easier to get than neurosurgery as a DO.
That is definitely exactly what I was thinking. I definitely could take a research year because I’m young, however NS is such a long residency and aren’t the greatest about women who want kids, I don’t want to limit my reproductive years even more - lol. I would find a hard time not having to do anything with the brain, but ortho is DEFINITELY a lot easier to get into for a DO than NS or I6 CT, but still towards the top for competitiveness. It is however a male dominated specialty by far, don’t know if that makes my chances worse or better. I think I’d be willing to compromise as i’d still be getting a piece of what I love. Thanks for the advice!
 
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longhaul3

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To me, those numbers just mean neurosurgery does more spine in their own practice. I.E. general neurosurgeons all do spine, but general orthopedic surgeons don’t. Comparing a neurosurgeon to an ortho spine surgeon, however, you would probably see similar numbers of spine surgery performed on a weekly basis. There are probably more spine surgeries performed by the ortho guys because they don’t do anything with the brain.

If 70% of neurosurgery is spine anyway, maybe OP should consider ortho spine?

Not like that’s super easy either, but ortho is at least a little easier to get than neurosurgery as a DO.
Right. I was addressing "I understand that ortho actually has to do the spine surgeries, how close are you with the neurosurgery team when working on things like that?" which to me implied that OP thought ortho is who "actually does" spine surgery. In fact it's a much bigger part of neurosurgery training than ortho training. There are also lots of neurosurgeons who only do spine.

I don't know who does more overall cases nationally. Despite only a small proportion of orthopedic surgeons being trained in spine, there are still nearly 10x more orthopedic surgeons in the US than neurosurgeons.

I agree that if you want to do spine surgery as a DO the more realistic way to do it is through ortho.

Thanks for this advice. Is there a specific way you should go about this, like an application, or do you contact faculty at the institution letting them know you’d like to do a research year and see if there’s any interest in one of them kind of mentoring you there to make connections?
This I don't know except that I know there isn't an application process. There are a few endowed research positions, mostly in ortho, at places like NYU and maybe UCSF. Otherwise I think you would have to reach out to the department. If anyone at your school has gone into neuro or ortho or any other specialty requiring extramural research, they would be the best people to ask.
 
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