Pursuing Neuro

[berrypie]

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I just finished M3 and my second-to-last rotation was Neurology. To my surprise, I fell in love with clinical neurology and I am seriously considering applying for a residency in Neurology.

I have several concerns:

1) I am not terribly interested in research. I should rephrase-- I don't have the personality or drive for doing research. I certainly respect those who do research, I just don't want to be the one doing it. I am far more interested in clinical practice and I would LOVE to teach neurology to medical students/residents. My question is-- how important is it to be interested in research (1) to get a position in a Neurology residency, and (2) to be a neurologist once residency is over?

2) Since I was caught by surprise by my Neurology rotation, I have NO other experience in Neurology and will be applying to residency quite soon. How often do Neuro programs receive applications from people who are newly interested in Neurology? Is there anything I can do in the next few months (other than do several clinical rotations in Neuro) to make it seem less random?

As I said before, I really loved my Neuro rotation, but it's hard to decide if this is a good fit for me based on a 1 month experience! Did anyone else have the same experience? What are the important things to consider when making such a big decision?

The other specialty I am considering is Family Medicine. Thought I'd throw that in for comparison's sake.

Thanks for the input 🙂
BP

 

[AlternateSome1]

1) Just don't strive for a research intense residency. Most programs will want you to get a basic amount of exposure, but there are a lot of clinically focused residency programs.

2) At many schools neuro is a 4th year rotation, and neurology used to be an early match (SF Match) specialty, so you aren't the first person to decide on neuro late. Just be able to explain why you are drawn to neurology and you will be fine. Don't try to apologize for your lack of experience, as it just focuses unnecessary attention to that portion of your application.

3) Assuming all other things are equal, go into family practice if you want to see all your patients for all of their problems; go into neurology if you only want to see neurological disease, psychiatric disease, and neurological complications of medical conditions and can do without the rest.

- AS1

I just finished M3 and my second-to-last rotation was Neurology. To my surprise, I fell in love with clinical neurology and I am seriously considering applying for a residency in Neurology.

I have several concerns:

1) I am not terribly interested in research. I should rephrase-- I don't have the personality or drive for doing research. I certainly respect those who do research, I just don't want to be the one doing it. I am far more interested in clinical practice and I would LOVE to teach neurology to medical students/residents. My question is-- how important is it to be interested in research (1) to get a position in a Neurology residency, and (2) to be a neurologist once residency is over?

2) Since I was caught by surprise by my Neurology rotation, I have NO other experience in Neurology and will be applying to residency quite soon. How often do Neuro programs receive applications from people who are newly interested in Neurology? Is there anything I can do in the next few months (other than do several clinical rotations in Neuro) to make it seem less random?

As I said before, I really loved my Neuro rotation, but it's hard to decide if this is a good fit for me based on a 1 month experience! Did anyone else have the same experience? What are the important things to consider when making such a big decision?

The other specialty I am considering is Family Medicine. Thought I'd throw that in for comparison's sake.

Thanks for the input 🙂
BP

 

[Doctor4Life1769]

Is neurology still an early match?

I have my 1st neurology rotation my 3rd month of 4th year (next month). Not sure if I'll fall in love with it, but I've come to enjoy neurology (during my step 2 studying). To be considered, would I need to do an audition/away rotation as well? Or not? do I need a letter from a chair? Or would any attending do?

Of course, I just want to collect info in case I happen to also like neurology while on the service.

Also, how competitive is neurology? I'm a DO student by the way, only took COMLEX 1 - average score.

Thanks

1) Just don't strive for a research intense residency. Most programs will want you to get a basic amount of exposure, but there are a lot of clinically focused residency programs.

2) At many schools neuro is a 4th year rotation, and neurology used to be an early match (SF Match) specialty, so you aren't the first person to decide on neuro late. Just be able to explain why you are drawn to neurology and you will be fine. Don't try to apologize for your lack of experience, as it just focuses unnecessary attention to that portion of your application.

3) Assuming all other things are equal, go into family practice if you want to see all your patients for all of their problems; go into neurology if you only want to see neurological disease, psychiatric disease, and neurological complications of medical conditions and can do without the rest.

- AS1

 

[AlternateSome1]

Is neurology still an early match?

No.

 

[Doctor4Life1769]

No.

Thanks. Any reply to the other questions I had posted?

 

[marqaha]

I am just an MS4 applying to neurology this year. So I don't know if I really know that much more than you, but here are my answers to your questions:

Away/audition rotations are not required in neurology as a general rule. You can find many examples on SDN of people that only did their required neurology rotation and got interviews at many "top" programs.

A letter from the neurology chair at your school would be best, but probably not required.

See this document to get an idea for how competitive neurology is. Neurology is more competitive than family medicine but less competitive than surgical and lucrative specialties.

I don't know about the D.O. thing. It seems that several "top" programs have D.O.'s and IMG's in them so I wouldn't worry about that.

 

[Doctor4Life1769]

Thanks!

I guess, the question lies, if I also need to have taken the USMLE? Or is an average COMLEX score (yes, the very average) acceptable? I know close to nothing about neurology since I'd not truly considered it (always thought it was a cool subject though), but with my upcoming rotation in it, in case I were to, I don't want to fall too far behind. I currently am into anesthesiology ... but, after doing a rotation in interventional cardiology, I'm becoming more open-minded. I just don't want to do IM or FP b/c I know I'd hate it ... and that's why I'm not going to try to pursue the cardio route either ... don't want to be doomed to general/hospitalist medicine if I don't get a fellowship.

I am just an MS4 applying to neurology this year. So I don't know if I really know that much more than you, but here are my answers to your questions:

Away/audition rotations are not required in neurology as a general rule. You can find many examples on SDN of people that only did their required neurology rotation and got interviews at many "top" programs.

A letter from the neurology chair at your school would be best, but probably not required.

See this document to get an idea for how competitive neurology is. Neurology is more competitive than family medicine but less competitive than surgical and lucrative specialties.

I don't know about the D.O. thing. It seems that several "top" programs have D.O.'s and IMG's in them so I wouldn't worry about that.

 

[marqaha]

I don't know about the COMLEX thing. But if you got an average score on USMLE, you would be fine. It's just a matter as to whether program directors will think of an average COMLEX as equivalent to an average USMLE. With all of that said, I still wouldn't try to take the USMLE step 1 at this point if I were in your shoes. That would be torture!

Good luck.

 

[Head]

In response to the original poster, I would try and put yourself in the shoes of those that are going to interview you for residency. Residency programs want candidates who are ultimately going to bolster their reputation by distinguishing themselves in their future careers. Most of the time this means a promising future in academic research. This is why MD/PhD's have their pick of residency programs (sometimes despite subpar clinical skills). Having said that, you can also have a distinguished career as a clinical instructor, teaching residents and providing excellent patient care. At least at my institution, we are looking for both of these types of people. When you go on your interviews, I wouldn't say you dislike research, just say you are very interested in being a clinical neurologist and teacher. What I can't stand is when interviewees come in claiming they really want to pursue research, when in fact they never have any intention of doing it and planned on private practice all the way. Mind you many people start out intending to do academic research and then the realities of life make them take that private practice job, but I digress.....

Now for your question about having enough experience in Neurology. As someone else posted, many med students do neuro as a 4th year rotation. That means no one has much experience and lots of people jump on the bandwagon last minute. In my mind you only need enough experience to get some solid letters of recommendation and to solidify your commitment to pursuing the field as your career.

 

[needinghope]

Hey guys,
I didn't pass my step 1 and was wondering if
1. Is it better to do extremely well the 2nd time around than to have a low score the first time?
2. One of my interests is neuro. Do you think I have a shot at it? (granted I did really well the next time around, and well in step 2 etc)?
3. Is dreaming of a GI residency unrealistic? What would my chances be What would I have to do to ensure that?

Thanks in advance for your feedback.

 

[abcabc1]

Hey guys,
I didn't pass my step 1 and was wondering if
1. Is it better to do extremely well the 2nd time around than to have a low score the first time?
2. One of my interests is neuro. Do you think I have a shot at it? (granted I did really well the next time around, and well in step 2 etc)?
3. Is dreaming of a GI residency unrealistic? What would my chances be What would I have to do to ensure that?

Thanks in advance for your feedback.

I'll give your questions a shot in order:

1. No. I'd rather have a low pass the 1st time, than a fail followed by an above-average score. Keep in mind, the chances of going from failing to off-the-charts between attempts is VERY low. The test deals not just with knowledge, but analytics, reasoning, overall test-taking skills and other factors that won't change between attempts.

2. Yes. You can match in Neurology, but many of the stronger programs are off limits to you at this stage. If you do well on Step 2 and on the rest of your Med School curriculum, you can match into a Neurology program. Keep in mind, your chances are (more or less) zero at quite a few programs at this stage. It's just the nature of the applicant pool. I'd be surprised to see you match at a program in the top 50% of all programs.

3. Yes, but there is still hope. I wouldn't say you can never become a GI doctor at this stage, but failing Step 1 was a MAJOR impediment. You're out of the running at all the elite programs, all the just-below-elite programs and most of the solidly-above-average programs. Your best bet is to match at a University based program in Internal Medicine (still possible) or a community based programm with its own GI fellowship. Research and solid performance at the Residency program will help, although nothing can ensure you will match.


I don't mean to sound too harsh, but failing Step 1 hurts your chances significantly. Best of luck!

 

[NeurologyICU]

Hey guys,
I didn't pass my step 1 and was wondering if
1. Is it better to do extremely well the 2nd time around than to have a low score the first time?
2. One of my interests is neuro. Do you think I have a shot at it? (granted I did really well the next time around, and well in step 2 etc)?
3. Is dreaming of a GI residency unrealistic? What would my chances be What would I have to do to ensure that?

Thanks in advance for your feedback.

While I don't know the answer to your question, here is an old thread from 2004, which had an identical question asked:

http://forums.studentdoctor.net/showthread.php?t=125223

This should give you optimism and hope. Unless things have changed drastically in the Neurology match (except going from SF to regular match) in terms of averages, then people can reject the opinions from the above thread.

 

[abcabc1]

While I don't know the answer to your question, here is an old thread from 2004, which had an identical question asked:

http://forums.studentdoctor.net/showthread.php?t=125223

This should give you optimism and hope. Unless things have changed drastically in the Neurology match (except going from SF to regular match) in terms of averages, then people can reject the opinions from the above thread.

I don't think Neurology is significantly more competitive now than it was at the time when the above thread was active.

That said, IMO, it's more than just the top 15-20 programs (as mentioned in the above thread) that are no longer in reach for someone who failed Step 1. This assumes the applicant does not have any very unique attributes that can help compensate for the Step 1 deficit (for example, 10+ publications, etc.). Even with solid clinical grades, many programs are out of reach.

 

[neurolddoc]

1) I am not terribly interested in research. I should rephrase-- I don't have the personality or drive for doing research. I certainly respect those who do research, I just don't want to be the one doing it. I am far more interested in clinical practice and I would LOVE to teach neurology to medical students/residents. My question is-- how important is it to be interested in research (1) to get a position in a Neurology residency, and (2) to be a neurologist once residency is over?


BP

I can speak to the last point. A research background is unimportant in private practice. While a few practices participate in clinical trials, your research, particularly basic research, will not be relevant to private practice. In fact, when we get CV's from residents looking for jobs from highly academic programs who are extensively involved in research, we scratch our heads and wonder why the sudden change.

 

[neurologist]

when we get CV's from residents looking for jobs from highly academic programs who are extensively involved in research, we scratch our heads and wonder why the sudden change.

Top 10 reasons:

1-8. Impending loan repayments.

9. Geographic considerations

10. They were just "playing the game" in residency/fellowship and were never really all that interested in research to begin with.

 

[bustbones26]

Hey guys,
I didn't pass my step 1 and was wondering if
1. Is it better to do extremely well the 2nd time around than to have a low score the first time?
2. One of my interests is neuro. Do you think I have a shot at it? (granted I did really well the next time around, and well in step 2 etc)?
3. Is dreaming of a GI residency unrealistic? What would my chances be What would I have to do to ensure that?

Thanks in advance for your feedback.

1. Just pass the damn test! I suppose it would look good if you do extremely well the second time around, but overall, be prepared to answer why you failed it at an interview.

2. YOu do have a shot at neurology. I think sometimes on this forum we live in a bubble and talk about Partners, UCSF, Johns Hopkins, Mayo, etc. Of course those are all great programs, but there are other less well known programs out there that will train you well and give you a chance too. Don't forget to apply to them as well.

3. GI versus neuro? I suppose you have to make up your mind. Keep in mind for GI that means doing IM first and then competing for the fellowship. Not impossible, but competition and years of extra training. Almost like doing two residencies. And it is competitive. Of course, if you do well in an IM program, you have a chance

Pass the tests, you can never be too prepared for the next step, keep studying, keep passing the tests, and then apply. Just be realistic with yourself, you have a shot, but you may not be some programs first choice.