Neurosurgery is wild to try and get into, but if OP has a genuine interest in it, I honestly think they will face less of a hurdle getting into a neurosurgery residency as a DO than they would fighting for an MD with their current stats. I don't have their full application, but if this interest is something that comes through in their writing, I think it has a negative impact. Few adcoms will look at an applicant with a less than 510 MCAT and that academic history and think "Yeah, this guy is gonna be competitive for neurosurgery". Neurosurgery also values research so much and OP has no real research experience from what I saw. OP gives no reason to think they would succeed in that pursuit at the current moment, which is why I think it may be hard with the MD (and just how much a ****show current MD admissions are).
Now, if they get into a DO (hell maybe even look into a DO/PhD), OP can reinvent themselves and start from scratch. Yes it is still uphill, but less than I think it may be for MD at this moment. Either route they take, if they want to be a physician they need to maximize their chances of getting into a program before starting to say "I wanna be a neurosurgeon".
We can't say numbers aren't everything and then bash people's head in with numbers. I think you and I have been here long enough to know that the meta "game" of admissions goes way beyond that and in reality is much
more difficult than most applicants realize.
It's just my opinion, but I think OP can shoot for MD in some future. It will take an MCAT retake, 4+ additional years of interesting experiences, and some impressive accolades that they don't already have. They will need to stand out in ways nobody else has before, and that's a really tall order considering this is the most challenging trans-academic contest that exists in professional education.
The problem is that the opportunities to do so, the stability to execute it, and the rewards of overcoming absurd statistical challenges are not guaranteed. So it's not that OP "can't" do it cognitively... it's just not accessible or worth it for 99.9% of people in this particular situation. It's not fair, but that's life.
With regard to NSGY in particular, it's mostly a red herring because most students change their mind. I agree with you insofar as waxing poetic about The Most Highly Compensated Prestigious Specialty
(™) is probably not the best choice optics-wise because it is so competitive and the inroads to medicine for this particular applicant don't lend themselves to
presenting in that way.
The file is just not externally consistent like you said, and it is a problem because if OP has no desire to become a physician outside of the desire to do NSGY, the adcom might feel like they are doing OP a kindness by rejecting them. If OP will not match NSGY and would be devastated scrambling into FM at a malignant program despite all of the red flags... caveat emptor, as the Sheriff of Sodium says.
There is such a thing as doors closing in this profession, but it's hard to tell because you can't physically watch them close. The opportunity just never materializes and you realize it all
after you've done all the work and overextended yourself in ways you didn't think possible.
Ultimately, I don't know OP's situation, but I do know I've been through pretty harsh times and it never got any easier all by itself. I had to make hard choices and often fell short of what I pictured for myself, sometimes devastatingly so.
It's just time for them to make a hard choice. It could be the best one they ever make, or could absolutely ruin their lives in ways that I would find personally impossible to cope with. But who knows. My risk tolerance is different from theirs, and yours, and everyone else's.
