Guideline about making it in neurology residency

[Orestis]

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Hello guys,

I am a 5th year medical student from EU. Tomorrow I am taking my step 1 exam, it looks like I am gonna score somewhere between 230 and 240. I know this number is not great but it is kinda ok for neurology. My main concern about picking a neurology residency program is their research abilities as I wanna do both hospital work and research.

After searching on FREIDA several neurology programs I realized that the step 1 score range was(in most of them) 220-240. Only one that was 240+ was Mayo Clinic. First of all is this a reliable source? It seems kinda low...

I know that LORs are very important and for this reason I am planning on doing an elective next year in USA(I will start applying when I get my step 1 score). Does 1 elective correspond to 1 LOR or can I get 2-3?

After talking with a family friend who is a doctor and has some friends who were IMGs and now doing residency in USA he insisted that since neurology is not so competitive I shouldn't worry much about my score(he actually said "just pass"). He also said I should focus on doing as much electives as possible to a specific hospital and then apply for residency on that one.

I guess most of the people in this subthread are either neurologists or want to become neurologists so you will have a better understanding of the whole process. Could you answer any of my questions(especially the amount of LORs/elective)? Or maybe provide me with a guideline on what to do from now one? I would really appreciate any help I could get.

P.S. I am working in a research group for 3 years now. Probably until I finish uni I would be 2nd author of 3 papers.

Thanks

 

[typhoonegator]

You can get as many letters as you want, as long as you spend enough time with someone that they feel comfortable writing a letter. But you don't want just any letter, you want a strong letter that demonstrates familiarity with the applicant and personal experiences to back up their recommendation. I write a lot of letters of recommendation, but very few strong letters. The people reading the application will know the difference, particularly at quality programs. So don't focus on the number of letters, but rather the number of intensive mentoring experiences that can lead to a strong letter. In a four week elective, three decent letters sounds like a stretch.

I agree that personal faculty experience with an applicant, particularly an FMG, is more important than scores, but the scores are relevant and shouldn't be neglected. People want to know you're competent, and even if neuro isn't incredibly competitive, well-regarded programs still have the ability to choose among people who they think are not going to be behind in clinical knowledge or otherwise problematic for their residency.

I'm not sure that doing 4 electives in one place really increases your chances compared to doing 1 or 2 with faculty who are prominent and involved with the residency. You might consider focusing on a few places rather than just devoting yourself entirely to one. Electives are a great opportunity to shine, but not everyone ends up making the impression that they'd like to, or matches well with that particular faculty member on a personal level. There is some risk involved.

 

[Orestis]

Really helpful info. Thank you.

 

[Thama]

As an FMG, you are much more of an unknown with regard to the quality of your education. If you come from somewhere like England, France or Germany this is less of an issue, but most of the rest of the EU is not seen as being equivalent to US MD training.

Programs look more closely at your step scores with this in mind, as it is a way to easily compare your performance to US students. Your grades at home will mean less because there is no context for the environment they were obtained in. The other thing programs want to see is that you've done multiple rotations in the US to ensure you can perform in that system and know what you're getting into.

Don't bank on Neuro being uncompetitive. It's at least as competitive as IM, and a different level than FM or psych altogether. For the profiles I've seen from our recent interviews at least half would have matched into literally any specialty they wanted. I don't know where that FRIEDA data comes from but I can tell you that Mayo is far from the only program averaging well above 240s in step 1.

 

[NeurologyHopeful2018]

As an FMG, you are much more of an unknown with regard to the quality of your education. If you come from somewhere like England, France or Germany this is less of an issue, but most of the rest of the EU is not seen as being equivalent to US MD training.

Programs look more closely at your step scores with this in mind, as it is a way to easily compare your performance to US students. Your grades at home will mean less because there is no context for the environment they were obtained in. The other thing programs want to see is that you've done multiple rotations in the US to ensure you can perform in that system and know what you're getting into.

Don't bank on Neuro being uncompetitive. It's at least as competitive as IM, and a different level than FM or psych altogether. For the profiles I've seen from our recent interviews at least half would have matched into literally any specialty they wanted. I don't know where that FRIEDA data comes from but I can tell you that Mayo is far from the only program averaging well above 240s in step 1.

My home PD told me that its been a record year in terms of both the quality and quantity of applicants.

Can you confirm?

 

[typhoonegator]

My home PD told me that its been a record year in terms of both the quality and quantity of applicants.

Can you confirm?

Impossible question, as applicant pools at each program ebb and flow every year. You would need broader trends for that, and given so many things associated with quality of applicant are not quantitative, I have little trust in the utility of things like Step 1 scores. Numbers of applicants may be relevant nation-wide, but individual programs can vary greatly in their applicant numbers year-to-year. Sounds like your program is having a great year, and that's good to hear, but it will be hard to figure out if that is true across the board until the dust settles after the cycle.

Judging by my experience modding SDN, the feedback from the commentariat is that neurology becomes FAR more competitive every year, such that by next year, it will be easier to become an astronaut than to match at a categorical neuro program. Everyone has it the hardest. Human nature.

 

[AThousandTrees]

My home PD told me that its been a record year in terms of both the quality and quantity of applicants.

Can you confirm?

For what it's worth, my PD said the same thing for this year. Also on the trail, seems like record numbers of people from the top schools are also applying for neuro...

 

[Orestis]

Hello guys,

Got my results back. 228. I guess it is a decent score. I know that average for IMGs in neurology that matched was 235. Do these 7 points play an important role?

 

[NeurologyHopeful2018]

Is it for Step 1 or 2? Step 1 thats good, step 2 needs to be above 230.

 

[Orestis]

It's step 1. I was checking with memorag, it was an applet that let's to put your scores and it tells you the chances you have using this score. For an non-US IMG with step 1 228 it gives me a chance of 62%.

Is it for Step 1 or 2? Step 1 thats good, step 2 needs to be above 230.

When you say it's good. Just to make it clear, I am searching for a good hospital (let's say top 100) so I can do research. Is that doable. Also thanks for the fast reply.

 

[deathmerchant]

With just one Step score, no one can predict anything. If you score 230 on step 2, have average letters and have a remote YOG with no research or USCE, your chances will be extremely low to match anywhere. But if you score > 235, fresh grad with USCE/research and great letters, you might match somewhere.
Also, there are probably less than 60-70 programs that realistically take non US IMG's(there are probably close to 120 total neurology programs in the country) Getting into a top 20-25 out of those would be extremely difficult unless you have something that stands out in your application.

 

[NeurologyHopeful2018]

As an AMG - 220 Step 1; 230 Step 2 will pass filters for most of the institutions. I don't know the cut offs for IMG unfortunately.

 

[Orestis]

I have some research experience, probably I couple of papers until I finish med school. I guess these would be helpful but I don't know how is the student research in USA. Is it a common thing? Or a few people do it?