Hey lipoyl,
Well first off, thanks for the compliment. I still don't understand the temperment of my fellow physicians sometimes in terms of hiding or sugar coating the truth. There are other ways to make the money a physician makes, but in the end, none is as humanly satisfying as medicine. The fundamental choice in your life that you will have to make is...do you want medicine to compliment your life, or do you want medicine TO BE YOUR LIFE? There is nothing wrong with either...medicine needs both types. I have other interests, and I believe my family will be of paramount importance to me someday (not having a family currently, but planning to have one evenetually). My reasons for wanting to be a neurosurgeon were wrong (an off-line discussion for another time). Your's appear to be far more right. Well, on that note...let me answer your questions.
Ok..let me repeat, the two most important things to recognize in the neurosurg match is ONE: Research, and TWO: LETTERS! Now, basically, you will have no problem matching wherever you want to go...if it's an extremely competitive school that you are at then you probably don't have an AOA system, so no one is really going to care about your status. I was AOA and 238, but what helped me more than anything else was I made a rapport with the attendings. In fact, in my interviews I would (outside of getting obtuse questions about family members, dedication and death) have to chat up how amazing the attendings were who had written letters. "Aah, I remember when X and I were at Hopkins together. He was a master of the cerebral aneurysm even back then. Just an absolute vision for neurosurgical anatomy. He could clip Giant, Berrys...it didn't matter". Your job was just to nod your head in agreement, maybe toss in a quick anecdote yourself. So, in conclusion, get the real advice from me. FIRST, DECIDE IS THIS REALLY WHAT YOU WANT TO DO WITH YOUR LIFE. If it is, tell your wife YOU WILL NOT SEE HER FOR THE NEXT SEVEN YEARS. This is an amazing women who will put up with this, but if she does and you can handle it, then go for it. Once you've commited, make sure you pick one program THAT IN YOUR MIND IS OUT OF YOUR REACH (try west coast...U of W, UCLA, and UCSF/STANFORD are all very competitive...Stanford all things considered is pretty benign), and do an away rotation in July or august, preferably July (sign up for that away rotation as soon as they will let you DURING YOUR THIRD YEAR...because the spots go fast). GET YOUR LETTERS NOW, two from general, two from neurosurg (I'll explain why two from general a bit later). Send out for applications in April, May and June of your final year. Get everything ready before you do your away in July. IN YOUR AWAY ROTATION (only do one, if you do two you won't get your apps out in time...and that stuff is a lot of work)KISS EVERY ATTENDINGS ASS YOU CAN...AND BE DISCRETE. Meaning, don't make it overt, but be a gunner. Go after good cases, with the world reknowned people. Get face time. This is very important. PRESENT YOUR RESEARCH AT ONE OF THE GRAND ROUNDS. YOU NEED TO DO THAT...it will provide you a great letter from the chairman at the worst, and at the best you will lock up a spot there (they will basically not even care about your scores, which are more than good enough to match by the way). I had a friend who gave a talk at his away rotation at the university of Florida, and literally PULLED OUT 45 SLIDES. Guess where he matched without being AOA or even cracking 220 (that's right). Now, get all your app stuff done by mid august at the latest. Send it out, and YOU WILL GET A TON OF INTERVIEWS. By the way, submit a few for general surg. as well. YOU WILL MATCH ANYWHERE FOR GENERAL SURG., your scores are good enough and it's just not as competitive anymore. That is not even a concern. ANY ONE OF THE PROGRAMS YOU LISTED WILL SALIVATE FOR YOU. So count that, and just submit to who you'd want to go to.
NOW...NEUROSURG...do the same. Send it to those programs you want to go to (30 programs). Ask you chairman for some advice (in the OR or whenever), and apply. I AM GUESSING YOU GO TO HOPKINS; it is up to you whether you want to get a letter from Dr. Carson. Ben is a great guy, from my hometown, wonderful person, but as well know as he is there are many neurosurgeons who do not like him (call it professional jealousy, call it what you will). It is your option; I forgot the name of the chairman there, but he's pretty world famous as well. Anyway, choose two (and maybe three with the chairman of the away program), and with your research and your board scores, YOU ARE A LOCK. My reco...go to University of Michigan. Great program, seven years, and genuinely good staff there. Any other questions, you can just reply. Take care good luck, and sincerely ask yourself is this what you want to do with your life. BECAUSE THE QUESTION IS NOT WILL YOU MATCH...the question is where, and do you want to?
Take care!
Brownman