I probably should do a home sub-I first and and go away for 2 more. I am not doing away rotation for trying to match in those institutes because I know probably my chance is slim, but more like to get to know people, get chance to see what others are doing and experience a little bit of different environment, and of course, it will be super if I can get some high power LORs.
I wonder: program always say, yea, we look at the whole package, blah, blah, blah, but when it comes down to select interview candidates, what matters to them the most? I read some stories similar to my situation with low step scores and mediocre clinical grade, but their feedback is they are still in a shock that they are actually matched. so I will guess it is largely depends on how lucky you… it is gonna be a nerve racking year…

What aspect of your application “matters most” is obviously going to depend on the person and the program looking at your application. In general, however, my guess would be that most PDs in neurosurgery value personal impressions most highly, garnered from your letters of rec and feedback from attendings and residents you rotated with. My feeling is that this is not the case for most medical specialty applications, but perhaps it’s this way in neurosurgery because it’s a small and grueling field where everyone knows each other and people are very co-dependent on each other for a long time, so trust and work-ethic are particularly important.  I think clinical grades and boards are obviously very important, but somewhat secondary. Research is also important for academic programs, but might rank third after LOR/word of mouth and grades/scores. Just my general impressions.

nothing matters more than the impression of you in person during the interview. you can take the best applicant (on paper) and have them bomb the interview because their personality. Alternatively, you can take a medicore applicant (on paper) and rock the interview w/ their personality. The second applicant has a much better chance of matching at that program.  in the end, the attendings have to spend 80+ hrs / wk w/ you for 6-7 years. they would much rather have a nice person w/ B+ credentials than an asshole w/ A+ credentials.

DoItLive - 11 February 2010 09:27 AM

What aspect of your application “matters most” is obviously going to depend on the person and the program looking at your application. In general, however, my guess would be that most PDs in neurosurgery value personal impressions most highly, garnered from your letters of rec and feedback from attendings and residents you rotated with. My feeling is that this is not the case for most medical specialty applications, but perhaps it’s this way in neurosurgery because it’s a small and grueling field where everyone knows each other and people are very co-dependent on each other for a long time, so trust and work-ethic are particularly important.  I think clinical grades and boards are obviously very important, but somewhat secondary. Research is also important for academic programs, but might rank third after LOR/word of mouth and grades/scores. Just my general impressions.

You mention that Neurosurgery PDs in particular care about word of mouth and LORs when it comes to residency applicants. In your opinion, which specialties (either competitive or non-competitive) are less based on this and more on the grades (Step 1, clinicals, AOA, etc) and research? Thanks so much!

uditnarayan - 11 February 2010 06:35 PM

You mention that Neurosurgery PDs in particular care about word of mouth and LORs when it comes to residency applicants. In your opinion, which specialties (either competitive or non-competitive) are less based on this and more on the grades (Step 1, clinicals, AOA, etc) and research? Thanks so much!

Udit: it seems that you have a good standing on the application part - why not start working on impressive interview skills rather than limiting your options? lets make our application as comprehensive as possible. my 2 cents..

From my experience, I think your LOR are one of the most important aspects of your application as well.  However, this is likely true for any surgical specialty, but probably particularly the smaller ones like NSGY, urology, and plastics, where almost all academic surgeons know each other (I’m guessing true for ENT, Ophtho, and Ortho to a certain extent as well).

I think research, Step 1 (at all of my interviews, I was never asked about not having a step 2 score), neurosurgery grades, and extracurricular activities are all particularly important as well, and were all focused on during interviews.  Clinical grades/AOA were only mentioned at 1 of my interviews.

With that said, I got the impression at several interviews that the decision was heavily based on your paper application, and the interview just confirmed that you would be ok to work with, so it is anyone’s guess what actual discussion go on about applications behind closed doors.  However, other programs seemed to place a very strong emphasis on the interview and the residents’ impressions of the applicants during the dinner and any down time during the interview.

Overall, I would say that each program places emphasis on different areas, and it is some combination of letters/grades/AOA/Step 1/research/activities/personality at each place.

question along those lines....if you get AOA do specific grades matter anymore (besides the neurosurg grade of course)?