Incoming M1 interested in neuro - Need advice

[NeuroMed6]

Hi all,

I am very fortunate to have been accepted to a T5 school. I have been involved in MCI and AD research, but I don't have any major pubs yet. I'm truly interested in pursuing neurology (I understand that this could change in the future) at a top academic institution. How can I go about being more productive/efficient in med school in terms of research?

There are many great opportunities at my home institution that it is almost overwhelming. Would you recommend reaching out to different neurologists here for shadowing? If so, which subspecialties should I look into to gain more exposure to the field? Thank you so much in advance for your advice!

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[CnsCrit]

If you find yourself with extra time (easier said than done), I'd start with a day or 2 shadowing inpatient neuro, and a day or 2 shadowing outpatient neuro. I would keep the exposure somewhat broad and try not to shadow anything too niche at first, since this will give you a skewed view of what neurology is actually like. For example, if you do a bunch of time with just neuro-ophthalmology or sleep clinic you won't be getting a realistic view.

If you do any neurology research and end up applying for neurology residency, thats good enough to make you competitive. If you liked AD research, then you could continue that - just know that although it's a very hot academic field, there aren't many neurology residents who chose it at the end of the day - I also did AD research early on and ultimately chose NCC. The chances that any med student starts neuro research of some kind and then ends up pursuing that same field as an attending would be very slim. No one will hold you to that. When you have time, just go with what seems interesting.

I find the most productive attendings are early-ish career folks who have some grant funding, are hungry to publish, and have protected time to do their work. If you just try to work with the most famous person you can find, they often tend to be stretched very thin and may not actually have the time to mentor or involve you in their projects in a meaningful way. Good luck!

 

[NeuroMed6]

If you find yourself with extra time (easier said than done), I'd start with a day or 2 shadowing inpatient neuro, and a day or 2 shadowing outpatient neuro. I would keep the exposure somewhat broad and try not to shadow anything too niche at first, since this will give you a skewed view of what neurology is actually like. For example, if you do a bunch of time with just neuro-ophthalmology or sleep clinic you won't be getting a realistic view.

If you do any neurology research and end up applying for neurology residency, thats good enough to make you competitive. If you liked AD research, then you could continue that - just know that although it's a very hot academic field, there aren't many neurology residents who chose it at the end of the day - I also did AD research early on and ultimately chose NCC. The chances that any med student starts neuro research of some kind and then ends up pursuing that same field as an attending would be very slim. No one will hold you to that. When you have time, just go with what seems interesting.

I find the most productive attendings are early-ish career folks who have some grant funding, are hungry to publish, and have protected time to do their work. If you just try to work with the most famous person you can find, they often tend to be stretched very thin and may not actually have the time to mentor or involve you in their projects in a meaningful way. Good luck!

Thank you so much for your response! That was very helpful. I will certainly keep that in mind

 

[JAK2-STAT3]

I’m in a similar situation as the OP, but my school is lower ranked and doesn’t have a neuro department or home residency. Is there anything special I can do to overcome any disadvantages? I do have neuroscience-related pubs from before medical school.

 

[Just D.O. it]

Is there anything special I can do to overcome any disadvantages?

If you are at a US MD school there is no disadvantage to overcome.

Make sure to pass your boards first try and that you don't fail any courses or rotations and apply broadly. You will not have a problem matching.

 

[JAK2-STAT3]

If you are at a US MD school there is no disadvantage to overcome.

Make sure to pass your boards first try and that you don't fail any courses or rotations and apply broadly. You will not have a problem matching.

Thank you that is a relief to hear!

 

[deleted1139416]

If you are at a US MD school there is no disadvantage to overcome.

Make sure to pass your boards first try and that you don't fail any courses or rotations and apply broadly. You will not have a problem matching.

Are DOs at a disadvantage?

 

[Dantes]

Are DOs at a disadvantage?

Somewhat, just like in all specialties. Neuro less so as it's historically not very competitive. However DO match rate went down from 92 to 84 this year for DOs, although I'd have to look up the sample size to see how meaningful that change is.

 

[NeuroMed6]

What are some of the reasons why neuro hasn’t historically been a competitive specialty?

 

[Doctoscope]

What are some of the reasons why neuro hasn’t historically been a competitive specialty?

Some reasons I've heard are dry/complicated subject matter, tough residency, and most importantly mediocre compensation. The $$$ is solid, but it isn't necessarily "good enough" to make it a competitive specialty. If neuro compensation increases dramatically, then I'd bet good money that it'd shoot up in competitiveness.

 

[deleted1139416]

Somewhat, just like in all specialties. Neuro less so as it's historically not very competitive. However DO match rate went down from 92 to 84 this year for DOs, although I'd have to look up the sample size to see how meaningful that change is.

I know it looks like a steep decline but I’m not sure if it really means anything. IMG and FMG match rate was nearly unchanged. Im guessing that it just might be a bunch of DOs who didn’t take usmle.

 

[Doctoscope]

Somewhat, just like in all specialties. Neuro less so as it's historically not very competitive. However DO match rate went down from 92 to 84 this year for DOs, although I'd have to look up the sample size to see how meaningful that change is.

I got curious and looked it up, and it looks like in 2022, there were 126 matched and 7 unmatched.

In 2023 advance data tables, looks like there were 148 PGY-1 positions matched by DOs. 84% match rate gives us ~28 unmatched.

17.1% of neuro programs were filled by DOs in 2022, and 17.5% filled by DOs in 2023, so it doesn't look like neurology is becoming any less DO friendly. I'm guessing the drop in match rate could be due to a combination of less-than-ideal applications and lack of geographical flexibility? Even in 2022 if you took Step 1 and got a score >220, you had like a 98.6% chance of matching.

(However, on the NRMP 2023 match video, they did they the neurology preference unmatched # was 16 applicants, which would give us 84 preference matched, so I could be using the wrong numbers/misunderstanding what the advance data tables mean.)

 

[Telamir]

What are some of the reasons why neuro hasn’t historically been a competitive specialty?

Cuz brain scary, mang.

 

[deleted1139416]

I got curious and looked it up, and it looks like in 2022, there were 126 matched and 7 unmatched.

In 2023 advance data tables, looks like there were 148 PGY-1 positions matched by DOs. 84% match rate gives us ~28 unmatched.

17.1% of neuro programs were filled by DOs in 2022, and 17.5% filled by DOs in 2023, so it doesn't look like neurology is becoming any less DO friendly. I'm guessing the drop in match rate could be due to a combination of less-than-ideal applications and lack of geographical flexibility? Even in 2022 if you took Step 1 and got a score >220, you had like a 98.6% chance of matching.

(However, on the NRMP 2023 match video, they did they the neurology preference unmatched # was 14 applicants, so I could be using the wrong numbers/misunderstanding what the advance data tables mean.)

The 2022 match rate doesn’t add up either. 126/133 = 94.7%, not 92%.

 

[Doctoscope]

The 2022 match rate doesn’t add up either. 126/133 = 94.7%, not 92%.

Yeah I was wondering why that was too. Maybe they made a typo on the charting outcomes?

 

[NeuroMed6]

Some reasons I've heard are dry/complicated subject matter, tough residency, and most importantly mediocre compensation. The $$$ is solid, but it isn't necessarily "good enough" to make it a competitive specialty. If neuro compensation increases dramatically, then I'd bet good money that it'd shoot up in competitiveness.

That’s interesting! But the field isn’t overly saturated right? Would you say that there is increased demand for neurologists due to the aging population of the US?

 

[HemeOncHopeful19]

That’s interesting! But the field isn’t overly saturated right? Would you say that there is increased demand for neurologists due to the aging population of the US?

There has been increased demand because of stroke center designations over the past decade or two. Every hospital in America wants a Neuro available 24/7 by telephone to qualify for the almighty “code stroke” money.

It turns out that works out well if you’re willing to work that type of call as an attending but it absolutely makes being a Neuro resident an awful proposition in my outside-looking-in experience.

When I think of other fields that need to be able to provide 24/7 urgent ER consult coverage with a relatively small number of trainees I think of Ortho, Neurosurgery, Cards, maybe GI/ENT to a lesser degree… all of those fields offer substantially better pay than Neuro as far as I know.

 

[deleted1139416]

There has been increased demand because of stroke center designations over the past decade or two. Every hospital in America wants a Neuro available 24/7 by telephone to qualify for the almighty “code stroke” money.

It turns out that works out well if you’re willing to work that type of call as an attending but it absolutely makes being a Neuro resident an awful proposition in my outside-looking-in experience.

When I think of other fields that need to be able to provide 24/7 urgent ER consult coverage with a relatively small number of trainees I think of Ortho, Neurosurgery, Cards, maybe GI/ENT to a lesser degree… all of those fields offer substantially better pay than Neuro as far as I know.

Would you say it’s harder to find a job as an inpatient or outpatient neurologist?

 

[HemeOncHopeful19]

Would you say it’s harder to find a job as an inpatient or outpatient neurologist?

No idea I’m an Oncologist - I was just providing my observations as an outsider with a few friends in Neuro