Realistically to what degree does school rank/prestige/connections play in matching?
Current M3 from a no-name MD school without a NSG residency, otherwise my app is built for nsg(26X/12+ nsg journal pubs/15+ conference presentations/all honors), but my school has absolutely no neurosurgical faculty and with sub-I's still being up in the air for the upcoming year i'm wondering if it would be necessary to take a research year just to make connections with another program even though I don't actually need more research?
That's a great question. The answer I think depends a little bit on what you want. School prestige carries some weight but much more than that it's your letters that really matter (probably about as much as Step I). School name just happens to correlate well to how well the faculty are known and the research opportunities that applicants have. There's no doubt that if you take a year off and do research at a well known place with some big name faculty and then Sub-I that you'll match at a great program. I also bet that if you could squeeze some Sub-Is in next year (and remember that as per the SNS rules, if you don't have a home neurosurgery program then you CAN rotate in person at another program, even during COVID) then you would likely match.
Long story short, if you just want to match and save yourself a year, then try and network as much as you can (fire off emails, try to set up Sub-Is for next year, etc.) and go for it. If your goal is to end up at a top tier place, take a research year at a big name program and work your tail off. Happy New Year!