Interested in Child Neurology: Could use some guidance

[helvetica]

Hi there,

Firstly, sorry for the obscenely long post. Now, on with the show!

I've been interested in child neuro for a while now and I want to start getting ready for residency applications, which I realize are a bit of a ways away (I'm a third year at a U.S. allo school and I promise I'm not a gunner 😀). I was hoping to get some guidance/advice from recent applicants about what I should expect when applying to programs since most of the administration at my school can't help me much and my mentor graduated from med school over 20 years ago.

1. From what I've seen around the forums, in general, this is not a super competitive specialty. I've looked at the stats from the NRMP for the 2012 Match and there were a large number of unfilled positions (I believe 17 or something), but I'm not sure if that's because those positions were advanced only or there really just wasn't much interest.

If possible, I would like some clarification on what competitive means for pedi neuro. I realize that Step 1/2 scores can be a touchy subject with some people, but what's the average Step scores at a top tier program (I'm thinking Boston Children's, CHOP, Seattle)? What about a middle-of-the-road program? I cannot find any of this information online (at least, none that's recent), so I was wondering if anyone could comment on it. I will probably call programs once I am on a less busy rotation schedule... good idea?​

2. How important is it to do an away rotation at the program you want to go to? I honestly don't know enough about what I want in a program to be able to make a decision about my "top choice" at the moment, but let's say it's Boston Children's for now (which is admittedly on my radar and likely out of my reach). I've heard mixed opinions about doing rotations at very prestigious hospitals that take medical students from top-tier schools because it could just make you look bad. I have no idea if this is sound logic or not. Can anyone provide any advice/info on this?

3. How difficult is it to find prelim peds programs for advanced positions? I haven't done my homework on this one as much, but is it generally difficult to find these 2-year programs that aren't associated with an advanced program?

4. Is it at all beneficial to do a whole 3-year pediatrics residency and do the child neuro Match a year after you graduate? To clarify: Is it helpful for getting into a better child neuro program? Is it helpful for your actual practice once you're done with residency? Does it give you an increase in pay? Is it easier to match in general because you don't have to find prelim programs?

I'm sure there are a lot of questions I don't know to ask yet at this point, but any and all advice (as a reply to this thread or a PM) would be GREATLY appreciated! 🙂

Thank you!

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[marele86]

Hey, I'm also planning to go into child neuro!

I can't answer your questions well, but I can tell you what other people have told me. Hopefully someone with more knowledge comes along and enlightens us both, though.

1. A resident at a top program told me their accepted students had an average USMLE of 235, though they ranged from 208 - 255. I think the people with the lower scores had some pretty baller letters of rec. (In general, everyone claims that USMLE scores matter less for pediatrics than your letters of rec and clinical grades. I'm a little too cynical to really believe it, but it'd be nice, right?)

2. Depends both on how competitive you are and how good of an impression you make. If you're a student from a newer med school with little to no clinical reputation, with mediocre numbers, who tends to impress the hell out of your residents and attendings - it'll help a LOT. If you're a little socially awkward and it takes you awhile to warm up to people, maybe not.

I'm thinking I might do an audition rotation at one of the more prestigious places, if nothing else, because I'm gonna need 3 letters of rec, and I can only think of 2 "well-known" pediatricians who know me well enough right now. I've heard well-known names go a long way - child neuro is a small field, after all. (Again, I might be being too cynical.)

3. This is tricky. Remember when childs neuro was in the San Francisco match, but regular pediatrics was in the regular match? Every single child neuro applicant was faced with the decision of whether to tell their interviewer they were also matching for child neuro. From what I've heard, very few did. ("Hey, accept me to your program! I'm gonna drop out 2 years in, though, so you'll have to completely re-do the call schedule and everyone will hate you" doesn't have a great ring to it.

And then there was the issue of when to spring it on them. You didn't want to do it too early, or else everyone would hate you and you'd get a terribly punitive schedule. But if you did it too late, it wasn't fair to the program. (This was apparently a big factor in why child neuro now is in the regular match. You should read their statement to the programs who now have to take 2-year prelim positions - it's pretty snarky. Something like "we don't expect taking our 2-year-only pediatric residents to be a significant issue, as you have been doing it unknowingly for years.")

Anyway. I want to know the answer to this, too. I like the idea of doing my first 2 years right here where I go to med school, then moving to do the next 3. Hopefully it's easier now that both options are in the same match.

4. I can tell you there's no increase in pay for being both a board-certified pediatrician and child neurologist. Child neuro is viewed as one of the rare specialties where, in exchange for extra years of training, you take a decrease in average pay. (Geriatrics is another one). People used to do it a LOT because they felt bad short-changing their prelim program by cutting out a year early, but that's apparently less of an issue now.

Let me know if you get any better information - I'd love to compare notes! It's rare to find someone else who's interested in this stuff.

 

[helvetica]

Thanks for chiming in! 🙂 Glad I'm not alone!

1. Awesome, that's more information than I had before! From what limited info I've seen online, a lot of programs just post a minimum cut-off score of either passing Step 1 or a 200. I haven't seen much else yet. I have heard the same thing about Step 1 with pediatrics. The way I view it, Step 1 is the screen, but once you've made it through the initial screening process, it's all about letters of rec, clerkship grades, and Step 2.

2. That sounds more reasonable to me. I guess I have to figure out which type I am...

3. Yes, I really want to know about this since the child neuro became a part of the NMRP. And wow, that's some serious snark!

4. Thanks for the info about the pay! I figured as much, but I still wonder about other aspects of a full peds training that might be beneficial.

Now, if only we could get some residents to chime in! 🙂

 

[tiredmedstudent]

I'm also planning to apply to Child Neurology at the end of this year! Unfortunately I don't know a whole lot about the application process either (no one at my school has applied to child neurology) but will hopefully learn more and pass it on!

 

[helvetica]

Thanks for chiming in and good luck!! Please let us know more if you can! 🙂

 

[dogsnme2]

Hi all,

First, congrats on deciding to go into child neurology. I am a second year pediatrics resident at a hospital in Philly, and will be heading to New York in July for my neurology training. I am happy to answer any questions that you may have about applying.

I'll start with the questions that the original poster asked...

If you have other questions, feel free to snd me a message.

Hi there,

Firstly, sorry for the obscenely long post. Now, on with the show!

I've been interested in child neuro for a while now and I want to start getting ready for residency applications, which I realize are a bit of a ways away (I'm a third year at a U.S. allo school and I promise I'm not a gunner 😀). I was hoping to get some guidance/advice from recent applicants about what I should expect when applying to programs since most of the administration at my school can't help me much and my mentor graduated from med school over 20 years ago.

1. From what I've seen around the forums, in general, this is not a super competitive specialty. I've looked at the stats from the NRMP for the 2012 Match and there were a large number of unfilled positions (I believe 17 or something), but I'm not sure if that's because those positions were advanced only or there really just wasn't much interest.

My answer:
I would say that child neurology is more competitive for foreign grads than for American grads. That being said, the top programs will be more competitive, even for American grads. However, you don't need a 235 on Step 1 to match. Many programs definitely use your step 1 scores as a cutoff for interview invitations. I am not sure what that cutoff is.

2. How important is it to do an away rotation at the program you want to go to? I honestly don't know enough about what I want in a program to be able to make a decision about my "top choice" at the moment, but let's say it's Boston Children's for now (which is admittedly on my radar and likely out of my reach). I've heard mixed opinions about doing rotations at very prestigious hospitals that take medical students from top-tier schools because it could just make you look bad. I have no idea if this is sound logic or not. Can anyone provide any advice/info on this?

My answer:
I don't think it's a bad idea to do an away rotation like that. I did not do one in child neurology, but it might have been helpful.

3. How difficult is it to find prelim peds programs for advanced positions? I haven't done my homework on this one as much, but is it generally difficult to find these 2-year programs that aren't associated with an advanced program?

My answer:
I applied through the SF match, so it was different. After I received my interview invitations for general pediatrics, I contacted each program director individually to let them know of my decision to pursue child neurology. I wanted to let them know for reasons that the second poster mentioned. Now that everything is being done through the regular match process, I think this issue should have been addressed, but I am not sure. I would contact eras or the individual programs (look at their websites if you don't want to contact them)

4. Is it at all beneficial to do a whole 3-year pediatrics residency and do the child neuro Match a year after you graduate? To clarify: Is it helpful for getting into a better child neuro program? Is it helpful for your actual practice once you're done with residency? Does it give you an increase in pay? Is it easier to match in general because you don't have to find prelim programs?

My answer:
The only reason to do the full three years of general pediatrics is if you are not sure whether that you want to go into child neurology. Both routes will make you eligible for the general pediatrics boards. One advantage to doing the full three years, however, is that you are bord-eligible for pediatrics at the end of the three years, and so you could theoretically moonlight as a pediatrics attending during the child neurology training.

 

[helvetica]

Thanks so much for your responses, dogsnme2!

Out of curiosity, do you think it matters if you prelim peds years at a different institution than the neuro years?

 

[dogsnme2]

I really don't think it makes a difference, one way or the other. The major advantage to doing everything in the same place is that you will get to work with the pediatric neurologists at that institution in some capacity. For example, when you consult neurology, you will have the opportunity to learn from the neurologists who will train you. You may also have the opportunity to do a child neurology elective, if your schedule allows, and you could do the elective at the hospital where you are working. Overall though, based on my experience, there is no difference professionally. Also, the combined programs are nice for people who don't want to move twice in five years.

Hope that helps!

 

[helvetica]

Just in case those of you interested hadn't checked out the NRMP data page recently, they've posted the 2012 program directors' survey, and child neuro is in it! Whoo!

http://www.nrmp.org/data/programresultsbyspecialty2012.pdf

Some highlights:

- the "safe" Step 1 score seems to be around a 220 (the average score above which most schools grant interviews)
- on average, 73% of applicants receive an interview
- on average, a program ranks 12 applicants for 2 slots
- DO/IMG friendly

I found an old SF Match PDF as well that said that in 2010, the average step 1 score for matched applicants was 225 (206 was the average for those who did not match).

 

[pedsmatch]

hi i have just decided during my ongoing Child Neur Elective to go ahead and apply to child Neur as well. The Problem is I applied to most programs i was interested in, for Ped. Categorical already !!
Questions..
1. Is it a good idea to apply for Ped Neuro Categ(5y) and Ped. Categ (3y) in the same Hospital?? though they're separate programs.. does it reflect badly on the ped categ programs when they find out you've applied to ped neuro categ in their hosp as well and vice - versa?
2. I realized child Neur has so many joint advanced + prelim .. so I will have to apply to the Ped. Prelim as well at a Program i have applied for Ped. Categorical already??
Does applying to prelim ped neur(2yr) at a program where you've also applied for Ped. Categ(3y) have a bad impression again??

I am interested in Ped Neur. but only after end of this elective i'll know more.. but i do need to apply now..
coz i snooze i lose !

 

[helvetica]

hi i have just decided during my ongoing Child Neur Elective to go ahead and apply to child Neur as well. The Problem is I applied to most programs i was interested in, for Ped. Categorical already !!
Questions..
1. Is it a good idea to apply for Ped Neuro Categ(5y) and Ped. Categ (3y) in the same Hospital?? though they're separate programs.. does it reflect badly on the ped categ programs when they find out you've applied to ped neuro categ in their hosp as well and vice - versa?
2. I realized child Neur has so many joint advanced + prelim .. so I will have to apply to the Ped. Prelim as well at a Program i have applied for Ped. Categorical already??
Does applying to prelim ped neur(2yr) at a program where you've also applied for Ped. Categ(3y) have a bad impression again??

I am interested in Ped Neur. but only after end of this elective i'll know more.. but i do need to apply now..
coz i snooze i lose !

1. I have heard that peds categorical programs frown on people doing only 2 years and then leaving, so I don't know what the answer to this is. :/ If you're applying to both because you don't know if you want to do peds neuro or not, I'm not sure how that reflects-- I guess it would be the same as applying for two different specialties at any institution. A lot of the advanced (PGY-3+) child neuro programs are starting to have their own peds prelim programs that they associate with, so I would think it'd be a good idea to apply to those programs.

2. I think the ideal is not to apply to the peds categorical and just go for the prelim if you want to do child neuro. If you don't know yet, it might be better to wait and apply to child neuro programs after you do one year of categorical peds so you can get an idea of what you like?

Obviously, I'm no expert on this stuff. I've been trying to do my research, but someone like dogsnme2 would probably be a better person to ask since they already applied and got into residency!

 

[dogsnme2]

1. I have heard that peds categorical programs frown on people doing only 2 years and then leaving, so I don't know what the answer to this is. :/ If you're applying to both because you don't know if you want to do peds neuro or not, I'm not sure how that reflects-- I guess it would be the same as applying for two different specialties at any institution. A lot of the advanced (PGY-3+) child neuro programs are starting to have their own peds prelim programs that they associate with, so I would think it'd be a good idea to apply to those programs.

2. I think the ideal is not to apply to the peds categorical and just go for the prelim if you want to do child neuro. If you don't know yet, it might be better to wait and apply to child neuro programs after you do one year of categorical peds so you can get an idea of what you like?

Obviously, I'm no expert on this stuff. I've been trying to do my research, but someone like dogsnme2 would probably be a better person to ask since they already applied and got into residency!

I was in a similar boat, wasn't 100% sure I wanted to do child neuro straight from med school, but I am glad I made that decision. I was actually partway through the application process before I ultimately committed to child neuro. Once I made the decision, I let the pediatrics programs know that I was planning to do child neuro, and asked them point-blank whether they would accommodate a 2year position. Most were willing to do so. When I applied, the child neuro was done through the SF match, and the pediatrics was done through the regular match. It is not an issue at this point that you applied to both the 3yr categorical and the 2yr prelim pediatrics spots at certain programs, but prior to submitting your rank list, you should definitely let them know what you are planning to do, so that they can make their list accordingly.

Good luck!!! Feel free to ask me any other questions.

 

[whiteprincess]

Hi dogsnme2,

Thanks for your super helpful reply! I spoke to a PD today with Child's Neuro, and even though I was just nodding my head throughout, I was still kinda confused. Thanks for clearing all that up.

Background, 3rd year med student, IMG, looking to apply for a competitive peds neuro residency at a Top 10 uni. Stats are not amazing by any chance, but I asked him point blank today, and he reiterated the fact that Step 2 scores were more important, and letter of rec. I'm also doing my research with the chair, planning to do my elective here as well.

My question is: there aren't many peds prelim program in the country. If i were to apply for the advanced position, do you really suggest i should let the PDs know that I am only intending to stay for 2 years? How will they view this, taking in account that I'm a measly IMG. Haha, sorry, I take pride in self-deprecation. Will they rank me lower, if at all, knowing this? Again, thanks!!

 

[Alcovesmb]

I'm about to start my 3rd year and I really want to do child neuro. Thanks for all the info!

 

[Anastomoses]

I'm genuinely curious...what attracted you guys to child neurology?

 

[shaggy alfresco]

Random question: If you do the five year program with 2 years in pediatrics, are you eligible to be a board certified pediatrician as well (like you would with a normal pediatric fellowship after a pediatrics residency?)

 

[thehomelessguy]

Random question: If you do the five year program with 2 years in pediatrics, are you eligible to be a board certified pediatrician as well (like you would with a normal pediatric fellowship after a pediatrics residency?)

Yes, but only after you are done with all 5 years (you can't sit for the boards after just your two peds years). This means a lot of people don't bother as they haven't done gen peds in 3 years. Also why pay money to take a test when there will be more than enough work as a child neurologist? Plus why subject yourself to additional CME requirements?

Previous people asked if there was any advantage to doing a full 3 year peds residency. One might be that, if you aren't a strong candidate, the advanced (non-categorical) positions often have fewer applicants, so it might increase your chances of getting in at a better institution (for example Duke has a couple of slots per year that are non-categorical). In that case you'd re-apply after doing one year of your 3-year peds residency. However, I'd only advise going this route if you try for categorical programs and do not match to any you like or have a compelling reason to stay somewhere (want to stay at your med school due to significant other etc.). It is essentially impossible now to find a separate 2 year pediatrics position unless it is in NYC or California where such still occurs to some degree. Otherwise definitely just go with categorical programs. The only other advantage to doing a full peds residency that I can think of is that you'll be a board licensed pediatrician while doing your child neurology training which may open up additional moonlighting opportunities to make some extra money. In most "good" pedi-neuro programs you are only doing call 1 weekend a month so if you are tight for cash you can supplement your income if you give up a weekend here and there (note a lot of places will have moonlighting opportunities for the pedi-neuro folks who are on the traditional path as well, but being licensed will make it easier to do a shift at outside/community hospitals/ER's if your program is okay with it). In fact, one could easily add a couple thousand a month (50%+ of their stipend) that way if they were a workaholic. Howevever, you'd still be better off just getting through residency faster and making a full physician's salary a year sooner with a 5 year categorical program.

 

[questies123]

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[AnonymousD.O.]

Hi,

I am a third year, looking for advice. I am interested in applying in Child Neurology, to 5 year combined programs. I need some advice about how competitive I am (which programs are realistic to me), and how I should structure my 4th year (should I do sub-Is? when)
-step 1: 269
-honors in pediatrics and neurology clerkships at a competitive medical school
-no research experience

thanks so much!

You got a 269 on step 1?

 

[Psai]

Hi,

I am a third year, looking for advice. I am interested in applying in Child Neurology, to 5 year combined programs. I need some advice about how competitive I am (which programs are realistic to me), and how I should structure my 4th year (should I do sub-Is? when)
-step 1: 269
-honors in pediatrics and neurology clerkships at a competitive medical school
-no research experience

thanks so much!

lmao what is this