Long time lurker here. It’s finally my 4th year, doing a couple sub-i’s, and trying to figure out where to apply.

I’m at UCSD and have done pretty well here. Honored all my rotations but Psyc in 3rd year. Was a Howard Hughes scholar at at NIH and got 2 publications (1st author) in with a couple more pending. Been active in a lot of extra currics etc.

The deal is this ... I got a 213 on my step 1. I way underperformed on it - was expecting to get a 240+ and obviously the unthinkable happened.

So my question is, do I even have a shot at applying to the top tier programs. Dream program would be Mayo - but my advisors are telling me not to do a sub-I at a top tier program because I wont have a good shot at matching there with my board score.

Would appreciate any advice!

Having just done this process, I think you should apply wherever you want.  Let them decide whether they want to interview you, don’t decide for them.  You’re from a good med school, have good publications/research and a hughes fellowship.  You will get interviews.  Be prepared to discuss your 213, and consider taking step 2 early so you have another (hopefully better) score to mitigate the first.  An excellent performance on a sub-i at Mayo, a much-improved step 2 score, and a good explanation for your 213 would go a long way toward matching there (or any other good program).

Apply to a WIDE variety of programs.  Apply to your dream programs, and also apply to programs that are less prestigious.  I found that I got a few interview invites from programs I thought I didn’t have a shot at and then got rejected by others that weren’t as well known.  You don’t know what EXACTLY each program is looking for or why they accept or reject certain people.  Your 213 is going to put you at a disadvantage, but don’t limit your possibilities yourself, let the programs reject you.  I would suggest doing away rotations at the best programs you are interested in and ALSO at less known program you are interested in.  I would tend to disagree with your advisors because you need to show programs that you can hang with the top programs.  A letter from a top chairman will go a long way; it will increase your chances of matching even if it isn’t at a “top” program.  At the end of the day all you need to do is MATCH to be a neurosurgeon - and I think rotating at a top program is going to help you do that.

I am also a tad (ok very confused about where to apply. What were the most important factors to those who applied before us? How did you even go about making a list?.
answered thanks

Honestly - as a place to start we sat down with the list of all 99 programs categorized by state and started crossing off the programs in locations we would never want to live, and circled the programs we were interested in, and slowly came down to the target number I wanted to apply to.  (I had a number in mind to begin with, and had about a dozen programs I knew I wanted to apply to, but also knew I needed to cast a larger net in order to get a decent number of interviews).  The number you need to apply to will depend on how competitive of an applicant you are.

scubasteve - 03 July 2010 03:58 PM

Honestly - as a place to start we sat down with the list of all 99 programs categorized by state and started crossing off the programs in locations we would never want to live

This is exactly what most of my attendings and residents have said as well. There are excellent training programs everywhere—if you hate rain, there’s no reason to spend 7 years at UW or OHSU.

That being said, since my location pref iis “somewhere on the east coast, or possibly the midwest”, that leaves a loooot of programs...it’s going to be wild!

thanks guys! I guess the most difficult thing is figuring out if you are “competitive” for certain programs. I think maybe I will apply to as many as possible and then do the writing down the list and crossing off, etc. I just hope I don’t run out of money

prettyinpink - 04 July 2010 08:46 AM

I guess the most difficult thing is figuring out if you are “competitive” for certain programs.

I think that’s a very good point—what is competitive, exactly. I know at my med school’s affiliated neurosurgery program (easily a top-10, research-heavy program), they take a wide look at things. we’ve had people with board scores in the 220s that had really cool experiences in other things (one guy built dams in third world countries in the peace corp for a while, for example).

My strategy will be to apply broadly on ERAS, since quite honestly, adding another 5-10 schools is an inconsequential sum extra $$ compared to not matching. Then, the programs can decide how competitive I am…

If you look at Charting Outcomes in the Match from 2009 (oh, how I desire those 2010 statistics), your odds of matching if you rank (ie, get interviews at) >12 programs is pretty good, and climbs even further, albeit slowly, as you approach ~20 ranks. Obviously, there are huge confounders in the mix, that is, extremely “good” applicants will get more interviews at programs (and presumably rank more programs)…