I know this is a broken record post but I am trying to plan aways and fourth year and could use some advice. I am a third year who recently decided to pursue a career in neurosurgery. My school does not have a neuro residency so I am looking for some direction and advice. I’ve looked over most of this website as to what it takes to match and find areas that I may be weak. Just a quick bio:

Top 25% of class, 262 Step 1, not AOA but maybe 4th year, honored surgery NBME but only passed OB/GYN (with a pretty low mark), Psych, Internal NBMEs with Family and Peds to go. Have 2 ongoing research projects (non-neuro related) but possibility of publication by interview season unsure. Good community service and class officer positions.

My biggest question is to gauge overall how competitive I may be coming into the game late with little direct academic experience? My only access to neurosurgeons is a private group but only one is really acceptive to students and a lot of what I read is to get to know surgeons in the field because it is such a small group.

Is waiting for away rotations in September and October too late (July I’m planning to take Step 2 and August spend a solid month with a private guy that gives students a lot of hands on experience)?

How bad does a low mark on a shelf look? My evals that will be on my deans letter were really good for the rotation.

With low amount of research and no home program how does that reflect on application?

Besides applying for aways, any suggestions in the meantime to strengthen my application?

I’ve been contacting as many people as possible but haven’t really had a chance to talk to many people with recent experience in applying for neurosurgery

Sorry if this is repetitive but any advice is appreciated. Good luck to those matching tomorrow.

Hi Horns,

I’m in a somewhat similar position.  The advice I got from my mentor was to do 3 aways asap.  As discussed on this board, Step 2 can be taken later especially with a strong Step 1.  As for research, could you throw an abstract together for the CNS deadline in a few weeks?  I have heard it mentioned that non-surgical grades are not as important as surgery.  Good luck.

Thanks. I’ll see what I can do about an abstract and think about delaying Step 2. Any other advice?

Horns 56: 
I was in your almost exact situation in that I decided on NSGY in March of my 3rd year, my home institution didn’t have a program and I was able to match in my top 3.  I would definitely not worry about taking Step 2 with a Step 1 like yours.  In my opinion, you’re much better off doing rotations than worrying about taking Step 2 (no one will seriously question why you haven’t taken step 2 with your phenomenal step 1 score)...plus you would be missing out on a nice consequence of blowing the doors off Step 1 and thats avoiding really having to study hard for step 2. 
Something you may also want to consider is to do a formal month (or even 2 week rotation) with the private guy you know who’s good with students.  Some medical schools are more open to this than others but if your school doesn’t have a NSGY program it seems to me they should be OK with this.  The benefit (in my view) of rotating with the guy you already know is that he can really show you the ropes in a no-pressure atmosphere so that you can really shine on your other aways.  Then again, the drawback is that this rotation has no benefit as far as being able to match with this group but you’ll look better when you start on your “real” aways.  Something else you could consider is using the 2 week break most schools have btw 3rd and 4th year to do your own mini-rotation with the private guy and still be able to save your other months for 3 aways.  I also wouldn’t worry too much about not having neuro-related research b/c as long as you have some research (which it sounds like you do), it shows you have academic and research inclinations that most programs like to see.  No matter which route you choose, you’ll be fine with your application as long as you work hard on your aways and get noticed for the right reasons.  Best of luck.

One other idea I would suggest - find out either through the matchlists posted here on UH or from match lists your school produces where some of your graduates have matched previously in NSURG. If any of those programs are of any interest to you (and those grads have done well/not been fired), I would give some consideration to including one of those programs among your aways. Don’t underestimate the fact that a program has a ‘history’ with graduates of your institution. You are going to meet a lot of people on the interview trail, and many of them are going to have outstanding board scores. You need something else to help you stand out. A pub or two would most certainly help. If a program has matched people from your school previously, and that relationship has worked out well, and as a bonus that grad is still in the program and can vouch for you, that could play in your favor.

Really appreciate the advice. All very helpful. “Chords”, that was my skepticism because all my advisors tell me “don’t worry you have great boards you will be fine” but I had the feeling that everyone has those scores so you need to stand out some other way. I decided to delay my step 2 and just hit the away trail early and am looking at schools where we have a resident. Anybody have suggestions on good solid programs that may not be considered “elite” where away rotations may not be so saturated with superstar applicants? I don’t really have a preference on location although SW would be ideal. Thanks again everyone for your advice. This website provides great advice.

To echo what was said earlier, do 2-3 aways that are chosen based on geographic region of interest, dream program based on what you want to do, and previous history of matching applicants at that program.  However, it sounds like you do “have nothing to worry about” as far as competitiveness is concerned.  Good luck, and feel free to PM me if you have any specific questions about programs or aways.

Thanks neurambo and I’ll be sure to PM if a question arises. I really appreciate everyone taking the time to give their input. Very informative. I’m open to any other advice as well. Congrats to all that just matched.

thanks for your sharing!