Thanks in advance for any insight given. I'm an MSTP finishing up my PhD (yes!) in NYC and am interested in neurosurgery (yes, I know about the time commitment, but I'd rather train forever to do what I want than take a short residency on the path to unhappiness). My question is, what do I need to do to get a residency spot (I want to stay in NYC, no less!)? My thesis work is in neuroinflammation, which I'm hoping will get me somewhere (I took the Step in '98, got an 85 and cannot recall the 3-digit score). I was told that for all residencies, clinical rotations grades count heavily too, but being an MSTP, I will be on the wards 18, not 24 months before graduation (and NS is an early match, no less). My backup plan is general surgery (with leanings towards a fellowhip in vascular). Advice? Am I insane or do I have a shot? Any comments would be greatly appreciated .