Neurology: What are my chances?

[r3ds]

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Starting to think about my residency application and was wondering how competitive I am for Neurology residency and how many programs I should apply to. I don't have the best scores and I have 1 potential big red flag (course failure). I am really interested in Neurology, always have been, and can't really see myself doing anything else. I would love to be at an academic program in a city and wonder if that is possible.

USDO
Red Flags: Course failure of my first course in the first year with successful remediation (I was a nontrad and hadn't studied for YEARS prior to med school so just hadn't well adjusted to the rigor of school, I guess).
Preclin/Clin Grades: nothing exceptional. normal student with no honors just passes.
Step 1/Comlex 1: first time pass
Step 2: 230 | Comlex 2: 490
Publications (including abstracts/posters): 10 (2 are neuro related but just case reports).

Any help would be appreciated! Thanks y'all.

 

[DrStephenStrange]

I’m positive that you’ll match somewhere. Just apply broadly and look for programs that have accepted DOs before (meaning NOT top 10-20 programs as most programs will accept DOs). Maybe consider doing at least a couple audition rotations — which could yield some strong letters (if completed before applications go out).

 

[TheHumbleAppendix]

Hows this the application cycle? I have similar stats.

 

[Aldertonghen]

If you do an away rotation with my program (or similar level- mid tier midwestern program), and perform well- you will match into our program with near certainty with that profile. Like the above poster mentioned- audition rotations are key for you

 

[r3ds]

Hi everyone! Came back to do an update because this is what I appreciated most about these threads in the past.

I applied to around 110 programs. The cycle is basically over now and I ended with 13 Interviews. I am really blessed to get the number of interviews that I did and I hope the match goes well for me. Crossing my fingers!

However, I believe, my interview #, is the direct result of the extremely high number of applications I sent. Many interviews were from programs and regions I never would have applied to with a lower # of overall applications. Paying an extra thousand or so hurts in the short run but has bought me some peace of mind that is priceless right now.

I also think that neurology has gotten more competitive for USDOs and gone are the days where it was relatively easy to get interviews at top programs. I don't know if those days ever were a thing but if they were, definitely not anymore.

Some potentially useful takeaways entirely from my experience (this applies to you if you are a USDO with similar stats):
1. DO NOT APPLY TO LESS THAN 70 PROGRAMS. The more the merrier honestly.
2. Based on the spreadsheets, 24x on step 2 is looking like a good minimum target (could go up who knows). I have seen people hit some decent top tier programs in neuro with that.
3. If your cycle also has 8 signals - USE SIGNALS AT PROGRAMS WITHIN YOUR RANGE AND HONESTLY "SAFETIES". This system seems to rarely work with reach programs. Use it on a program that is within your range that you would not want to go without an interview from in this app cycle. Also check their websites to see if they even look at signals.
4. I second what @Aldertonghen and @DrStephenStrange are saying. AUDITION AUDITION AUDITION. Send as many VSLO apps as possible for auditions and do as many as you can. I did 5 and 3 of my interviews were from auditions. You should go on as many auditions as you can. At least 3.

 

[DrStephenStrange]

Hi everyone! Came back to do an update because this is what I appreciated most about these threads in the past.

I applied to around 110 programs. The cycle is basically over now and I ended with 13 Interviews. I am really blessed to get the number of interviews that I did and I hope the match goes well for me. Crossing my fingers!

However, I believe, my interview #, is the direct result of the extremely high number of applications I sent. Many interviews were from programs and regions I never would have applied to with a lower # of overall applications. Paying an extra thousand or so hurts in the short run but has bought me some peace of mind that is priceless right now.

I also think that neurology has gotten more competitive for USDOs and gone are the days where it was relatively easy to get interviews at top programs. I don't know if those days ever were a thing but if they were, definitely not anymore.

Some potentially useful takeaways entirely from my experience (this applies to you if you are a USDO with similar stats):
1. DO NOT APPLY TO LESS THAN 70 PROGRAMS. The more the merrier honestly.
2. Based on the spreadsheets, 24x on step 2 is looking like a good minimum target (could go up who knows). I have seen people hit some decent top tier programs in neuro with that.
3. If your cycle also has 8 signals - USE SIGNALS AT PROGRAMS WITHIN YOUR RANGE AND HONESTLY "SAFETIES". This system seems to rarely work with reach programs. Use it on a program that is within your range that you would not want to go without an interview from in this app cycle. Also check their websites to see if they even look at signals.
4. I second what @Aldertonghen and @DrStephenStrange are saying. AUDITION AUDITION AUDITION. Send as many VSLO apps as possible for auditions and do as many as you can. I did 5 and 3 of my interviews were from auditions. You should go on as many auditions as you can. At least 3.

Bruhhh, are we the same person? The bolded parts were almost my exact experience 3 years ago. Applied to just over 100 programs and ended up with 13 interviews (some to programs I never would have applied to otherwise). Except I had a scored step 1, didn’t have step 2, had failure on my first attempt at level 2, and ended up with a lower score than you on my retake. I matched at my number 9 I believe. Back then I was happy and relieved I matched (beggars can’t be choosers), but disappointed I did not get my top 3. Now, looking back I am so happy I ended up where I did, and all I can say is that it worked out better than I ever would have anticipated.

However, as you said, It seems that things have gotten a lot more competitive, and DO students will likely need to focus on auditioning moving forward which is unfortunate. I would have expected more interviews especially with your step 2 and step 1. I think you will match though; with 13 interviews it’s like 99% chance that you do. Good luck!

 

[r3ds]

Hi Everyone,

I am still in shock, but I ended up going unmatched. Obviously my application was not the strongest but I assumed the # of interviews would have yielded success here. I also completed SEVERAL audition rotations in which I was led to believe I performed well. Sure, it could be possible I am bad at interviewing but I like to think that is actually one of my strengths and I only got extremely positive feedback from my faculty interviews and LOI email (I wish I could reach out to the PDs to find out what I did wrong). In the end, who knows. I guess becoming a neurologist as a DO with lower stats might be harder than I expected. The hope is this is just my n=1 and this does not happen to any of you.

Maybe this is a more cynical vent so lol skip over this if you would like -

[[But if I could go back, I would spend none of the time I did on extracurriculars, leadership, and research. I also would NOT listen to the advisors at my school who told me that (1) what matters first and foremost is how you perform in school (after my course failure, I ended up significantly improving my performance in school close to top half) and (2) that board scores do not matter for neurology so just focus on passing and sharpening clinical skills.

I would spend all of this time hammering boards material. I am realizing that maybe neurology programs don't care really at all about demonstrated interest in the specialty in the form of attending conferences, completing away rotations, getting good letters (I had 3 solid neuro letters) IF your scores are not fantastic.]]

Well anyways, as there are barely any available positions for the SOAP, I will be seeking any and all out of match scramble Neurology positions. Otherwise, I guess it is not in the cards for me to become a neurologist.

Thanks.

 

[FlaringRaynauds]

Dr. Stephen Strange called this along time ago in that Neuro has gotten more competitive. There is nothing worse than the Ill-Advisors at the schools. Sorry to hear about you having to SOAP. Hopefully you can get one of the 7 neuro spots in the SOAP.

 

[s5260205]

Hi Everyone,

I am still in shock, but I ended up going unmatched. Obviously my application was not the strongest but I assumed the # of interviews would have yielded success here. I also completed SEVERAL audition rotations in which I was led to believe I performed well. Sure, it could be possible I am bad at interviewing but I like to think that is actually one of my strengths and I only got extremely positive feedback from my faculty interviews and LOI email (I wish I could reach out to the PDs to find out what I did wrong). In the end, who knows. I guess becoming a neurologist as a DO with lower stats might be harder than I expected. The hope is this is just my n=1 and this does not happen to any of you.

Maybe this is a more cynical vent so lol skip over this if you would like -

[[But if I could go back, I would spend none of the time I did on extracurriculars, leadership, and research. I also would NOT listen to the advisors at my school who told me that (1) what matters first and foremost is how you perform in school (after my course failure, I ended up significantly improving my performance in school close to top half) and (2) that board scores do not matter for neurology so just focus on passing and sharpening clinical skills.

I would spend all of this time hammering boards material. I am realizing that maybe neurology programs don't care really at all about demonstrated interest in the specialty in the form of attending conferences, completing away rotations, getting good letters (I had 3 solid neuro letters) IF your scores are not fantastic.]]

Well anyways, as there are barely any available positions for the SOAP, I will be seeking any and all out of match scramble Neurology positions. Otherwise, I guess it is not in the cards for me to become a neurologist.

Thanks.

I'm sorry you did not match. The whole system is sometimes very frustrating. Not matching does not speak to your ability as a physician at all, just unfortunately the downside of a system like this.

The single pre-clinical course failure should not be a big hindrance to your application, and your states are otherwise good. Are there other things that may raise red flags in your applications? How do you think interviews overall went? If you were to become an unfortunate re-applicant, I would also look into whether LoR are really as billed.

 

[r3ds]

I'm sorry you did not match. The whole system is sometimes very frustrating. Not matching does not speak to your ability as a physician at all, just unfortunately the downside of a system like this.

The single pre-clinical course failure should not be a big hindrance to your application, and your states are otherwise good. Are there other things that may raise red flags in your applications? How do you think interviews overall went? If you were to become an unfortunate re-applicant, I would also look into whether LoR are really as billed.

Thanks, I appreciate the kind words from you and @FlaringRaynauds

Yeah, outside of the things I mentioned, I cannot think of any obvious red flags.
I think interviews went well but I don't know if thats a possible avenue of exploration unless I can directly reach out to PDs from the cycle (I did well in mocks with friends and faculty and the convos in the real interviews felt great).
And yes, if I end up having to reapply, I will revisit the letters of rec and maybe swap some out. However, its hard for me to fathom that the letters were not good because I had many sitdowns with the faculty that wrote them and we had good conversation and they showed me some early drafts and what they were thinking and it all looked great.
Hopefully I can get a TY/Prelim position, at the least, so it will be easier to get new letters and hopefully have better luck for out of match and physician reserved slots. I really do want to become a neurologist so I am not really entertaining categorical IM positions so hopefully it does not come to that.

 

[DrStephenStrange]

@r3ds I am very sorry to hear this man. That is the last thing I expected especially after you were able to secure 13 interviews and had some audition rotations completed. If you still want to do Neurology, I would go all out after those 7 SOAP positions like ASAP. If not successful in the soap, I think a TY or IM prelim (preferably at an institution with a neurology program) with plans to go after PGY1 and PGY2 spots next year is reasonable.

This is definitely not your fault or a representation of your own ability to become a neurologist. As mentioned above, I definitely did not think your application was weak by any means. I had an even weaker application 3 years ago, and thinking about it, there’s a high likelihood I probably wouldn’t have matched either (considering everything else being equal). I keep saying this and it is unfortunate, but it just seems that things are just becoming more competitive and that over 10 interviews is still not a guarantee that you’ll match in neurology.

 

[r3ds]

SOAP Update:

Small glimmer of hope. Just accepted an IM Prelim offer in soap. Did not receive any offers for Neurology. I will be going forward with this and hoping to apply for PGY2 Neurology positions both in the out-of-match scramble and in an ERAS reapplication cycle. The hope, albeit small, is still alive for me to become a Neurologist one day.

If anyone has any advice on how to go through reapplication in neurology or can keep me in the loop for open neurology positions in scramble, it would be much appreciated.

Otherwise, thanks again everyone for the kind words and suggestions and hopefully I have some form of good news to post in here in the coming months.

 

[DrStephenStrange]

SOAP Update:

Small glimmer of hope. Just accepted an IM Prelim offer in soap. Did not receive any offers for Neurology. I will be going forward with this and hoping to apply for PGY2 Neurology positions both in the out-of-match scramble and in an ERAS reapplication cycle. The hope, albeit small, is still alive for me to become a Neurologist one day.

If anyone has any advice on how to go through reapplication in neurology or can keep me in the loop for open neurology positions in scramble, it would be much appreciated.

Otherwise, thanks again everyone for the kind words and suggestions and hopefully I have some form of good news to post in here in the coming months.

Awesome man. Just keep working hard. Take Level 3 and do well. Keep your eyes peeled for any Neuro PGY-2 openings outside of the match throughout the year. Sometimes new programs open up both PGY1 and PGY2 spots at the same time too, so stay on the lookout for those as well. Otherwise, make sure you are meeting the ACGME requirements for what a neuro intern year should include in terms of rotations, so you can qualify for those PGY-2 spots in the match next year. Good luck with everything! Reach out anytime if you need any advice.