Disagree on the bolded. It may be OP's biggest hurdle (if that's what you meant), but to match into neurosurg you literally have to be the best of the best. That means 255+ STEP, 8+ PAPERS (never mind publications), AOA or Gold Humanism (preferably both), and other intangibles like spectacular evals. Getting into med school will be the easiest thing one does if they want to end up in neurosurg.
You do not have to have these ridiculous stats to match neurosurgery. You have to be an above average med student with an above average step 1. The median step 1 score in 2016 was 249, which is high, yes, and that's about 80th percentile. However, even if you have between a 231 and 240, you have a 60% chance of matching and
even if you have a 221-230, you still have a 50% chance of matching. Step 1 is probably the biggest hurdle once you're in med school to matching neurosurgery or other highly competitive specialties. 32% of students who match neurosurgery have AOA. It's not a requirement, not even close. Research is highly valued, but you definitely do not need 8 papers or even half that. If you don't believe me, pubmed search the names of current neurosurgery interns. You'll find plenty of them with 0-2 publications. Obviously if you're looking at UCSF interns, half of whom are PhDs, they'll have a lot more, but that's the exception, not the norm.
A non-AOA student from a mid tier school with reasonable clinical grades, a 240+ step 1, and 1-2 neurosurgery papers stands a very reasonable chance of matching neurosurgery. Are they going to Barrow, Columbia, or UCSF? Probably not, but they'll likely match somewhere. You are describing the type of applicant who is in the top percentiles of competitiveness at highly academic programs (like the ones mentioned before). Many of these residents will come from top schools, have 250+ step scores, AOA, and loads of research. But that's true in any specialty. The range in neurosurgery isn't like the range in IM where you can match community primary care track IM in Oklahoma with a 199, all low passes, and nothing else to show - you still have to be, as I said, an above average student with an above average step 1, and at least some research. But that's an attainable goal for many med students, not just the top percentile of students like you are saying. I guarantee you that you do not have to literally be the best of the best.
Would you say that is true for any specialty? Just curious. I would've imagined ortho or derm would be harder to get into than to get into because you have to be at the top in a class of the top people that were pre-meds. I realize that the match % for each specialty is probably much better than med school acceptance rates but I figured that was due to people who aren't competitive realize that and don't apply to specialties they don't have much chance in.
Just wondered!!
You don't have to be at the top of your class to match any specialty. You have to be at the top of your class to match to a top academic program in most specialties. ENT, Derm, and Plastics are a little different because they have such a high proportion of AOA students (Derm and Plastics are both 50% and ENT is a little lower), but that means that even in plastics, arguably the most competitive specialty, 50% of successful applicants are not AOA. Yes, if your advisory deans are good and you listen to them, people will self-select out of applying to specialties they aren't competitive for at all, but if you're flexible in terms of location and what type of environment you'll be training in, you have a lot more options available to you.
