(03-20-2018, 01:59 AM)SirVictorHorseley Wrote: Like others have posted, state school is a meaningless term when it comes to neurosurgery.
Where you went to medical school doesn't matter if you are an outstanding applicant. It matters a lot if you are a mediocre/average applicant. If you have high board scores (260+), a good publication record and great letters, you can match anywhere regardless of med school. If you are an average to below average applicant aka 240, minimal pubs, average letters, and are coming from a school with no home program or a very weak home program you might slip through the cracks. Whereas if you went to a top med school or somewhere with a strong program, school name and networking would probably get you a spot somewhere. A place with a strong program is also more likely to have good mentors who will tell you what you need to do to match, i.e. take time off for research etc. based on your application.
It is hard to get a good publication record if you are from a school with no program or a program that doesn't have residents/faculty who publish much. It is hard to get good letters outside your home institution, meaning it is hard to get good letters period if you don't have a home program. People do it every year, but like others have said it will require you to put in a lot of effort and initiative. That shouldn't discourage someone who plans on going into neurosurgery.
Also Berger letters are always useless, so whoever posted that clearly has never read one.
So for someone with a step 1 score of 240+ and from low tier state school (by that I mean not UVA, UNC or UF or Michigan. I mean schools like University of New Mexico, University of Nevada, University of Arizona, University of Kansas, etc.), there is slim chance to match to neurosurgery? I had wanted to be a neurosurgeon since college, but want to be realistic about my goal
its not that you can't be a neurosurgeon from smaller schools/less prestigious schools, its that its difficult to know how to prime yourself for nsg from those schools. by the time its third year, its generally too late to start in on nsg.
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(03-20-2018, 03:15 PM)Guest Wrote: (03-20-2018, 01:59 AM)SirVictorHorseley Wrote: Like others have posted, state school is a meaningless term when it comes to neurosurgery.
Where you went to medical school doesn't matter if you are an outstanding applicant. It matters a lot if you are a mediocre/average applicant. If you have high board scores (260+), a good publication record and great letters, you can match anywhere regardless of med school. If you are an average to below average applicant aka 240, minimal pubs, average letters, and are coming from a school with no home program or a very weak home program you might slip through the cracks. Whereas if you went to a top med school or somewhere with a strong program, school name and networking would probably get you a spot somewhere. A place with a strong program is also more likely to have good mentors who will tell you what you need to do to match, i.e. take time off for research etc. based on your application.
It is hard to get a good publication record if you are from a school with no program or a program that doesn't have residents/faculty who publish much. It is hard to get good letters outside your home institution, meaning it is hard to get good letters period if you don't have a home program. People do it every year, but like others have said it will require you to put in a lot of effort and initiative. That shouldn't discourage someone who plans on going into neurosurgery.
Also Berger letters are always useless, so whoever posted that clearly has never read one.
So for someone with a step 1 score of 240+ and from low tier state school (by that I mean not UVA, UNC or UF or Michigan. I mean schools like University of New Mexico, University of Nevada, University of Arizona, University of Kansas, etc.), there is slim chance to match to neurosurgery? I had wanted to be a neurosurgeon since college, but want to be realistic about my goal
Just go for it, Guest. Set up meetings with mentors outside your institution if you there are none to be found at home. If you want to reach your goal (be it realistic or not), you need to be proactive and dedicated.
It may be tougher but you can make it. Follow your passion. I came from a less than fancy med school with no home program, decided to pursue neurosurgery mid M3, and matched into what many would consider a solid tier two program. You may be less likely to match at a really fancy program, but if you work at it you can certainly match somewhere that will train you to be a competent surgeon and if you are a rockstar you may well do a lot better than that. Work hard, manage your expectations, and good luck!
(03-20-2018, 04:22 PM)Guest Wrote: It may be tougher but you can make it. Follow your passion. I came from a less than fancy med school with no home program, decided to pursue neurosurgery mid M3, and matched into what many would consider a solid tier two program. You may be less likely to match at a really fancy program, but if you work at it you can certainly match somewhere that will train you to be a competent surgeon and if you are a rockstar you may well do a lot better than that. Work hard, manage your expectations, and good luck!
Really impressive you could match so well starting so late. How much ns research did you have, if you don't me asking? Did you take a year off?
(03-20-2018, 04:22 PM)Guest Wrote: It may be tougher but you can make it. Follow your passion. I came from a less than fancy med school with no home program, decided to pursue neurosurgery mid M3, and matched into what many would consider a solid tier two program. You may be less likely to match at a really fancy program, but if you work at it you can certainly match somewhere that will train you to be a competent surgeon and if you are a rockstar you may well do a lot better than that. Work hard, manage your expectations, and good luck!
Thanks for the encouragement. I really appreciate it. I would be very grateful if you can share more details of your journey: what are your scores? Did you honored in all of your rotations? How many away rotations did you do? How many programs did you apply? How many interviews did you receive? Do you know where I can read more about the different “tiers” of the program so I can avoid the top tier ones?
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03-20-2018, 06:57 PM
(This post was last modified: 03-20-2018, 06:58 PM by Don.)
Don't avoid any programs. Apply widely, you can still make it to top programs with good scores, good research and solid LORs.
First, there doesn't seem to be consensus at all on what the 'tiers' are. There are several incredibly strong programs that are well known for turning out amazing and politically connected surgeons. You probably won't find agreement here about some of those, but most agree that a few are on that list. Maybe that is what you can call 'academic' programs or tier 1. They are incredible and when people want to find a way to talk trash about them they usually say something like they spend too much time in the lab and not enough time in the OR. Some of that is probably jealousy because they are fancy and some may be true of some of them.
There seem to be a lot of programs that turn out really great surgeons who operate independently and well but who may be somewhat less connected and less capable of name dropping. Maybe those are the more 'clinical' programs and are what people mean when they say tier 2. This is where strong applicants who come from less well-known programs will probably end up, but there are awesome underdog stories of surprising and probably well deserved exceptions to this.
Then there are a few programs that have lower call volume and fewer attendings. I don't think a program that can't provide the minimum numbers would survive, but one sees places where the operative volume and diversity are just lower. I imagine you can still come out of those places operating well, but you'll probably never be the program director at some fancy place if you train in those programs. Perhaps that is tier 3 if we want to call it that.
All of the above can and will be argued and you'll hear incredibly different thoughts from different people on these things. Some of that will be well intended, some will be based on jealously, some will be based on arrogance, and some will be just plain trolling. In the end ignore it all, work hard, apply broadly, and again manage your expectations and remember that if you work hard enough you get to train to operate on the thing that makes humans human.
I got mostly As in the basic science years, mostly honors in clinical rotations, and solid but not amazing score on step 1 and 2. I sought out local neurosurgeons who let me rotate with them, and one who involved me in his research. A lot of that was on my own time and out of my own pocket, to include travel to work on his research projects. I had published a couple of case reports in third year. I took what probably amounted to bad advice about when to schedule away rotations, and since my letters didn't all come from academic neurosurgeons two of them were a week late but they were from people who knew me well. I applied to over 80 programs, got around 30 interview invitations (few of which were to what most here would consider tier 1 programs), and went on about 20 interviews. I liked pretty much all of the programs that I visited and felt confident that if I worked hard enough I could feel good about my training at the end of most of them.
In summary, I did a few things wrong probably, but worked hard and did the best I could with what I had. My school was supportive, but didn't really know how to advise me since they rarely match anybody into neurosurgery. I feel incredibly honored to have matched where I did, and I can't wait to spend the rest of my life in neurosurgery regardless of 'tier'.
(03-20-2018, 06:58 PM)Guest Wrote: First, there doesn't seem to be consensus at all on what the 'tiers' are. There are several incredibly strong programs that are well known for turning out amazing and politically connected surgeons. You probably won't find agreement here about some of those, but most agree that a few are on that list. Maybe that is what you can call 'academic' programs or tier 1. They are incredible and when people want to find a way to talk trash about them they usually say something like they spend too much time in the lab and not enough time in the OR. Some of that is probably jealousy because they are fancy and some may be true of some of them.
There seem to be a lot of programs that turn out really great surgeons who operate independently and well but who may be somewhat less connected and less capable of name dropping. Maybe those are the more 'clinical' programs and are what people mean when they say tier 2. This is where strong applicants who come from less well-known programs will probably end up, but there are awesome underdog stories of surprising and probably well deserved exceptions to this.
Then there are a few programs that have lower call volume and fewer attendings. I don't think a program that can't provide the minimum numbers would survive, but one sees places where the operative volume and diversity are just lower. I imagine you can still come out of those places operating well, but you'll probably never be the program director at some fancy place if you train in those programs. Perhaps that is tier 3 if we want to call it that.
All of the above can and will be argued and you'll hear incredibly different thoughts from different people on these things. Some of that will be well intended, some will be based on jealously, some will be based on arrogance, and some will be just plain trolling. In the end ignore it all, work hard, apply broadly, and again manage your expectations and remember that if you work hard enough you get to train to operate on the thing that makes humans human.
I got mostly As in the basic science years, mostly honors in clinical rotations, and solid but not amazing score on step 1 and 2. I sought out local neurosurgeons who let me rotate with them, and one who involved me in his research. A lot of that was on my own time and out of my own pocket, to include travel to work on his research projects. I had published a couple of case reports in third year. I took what probably amounted to bad advice about when to schedule away rotations, and since my letters didn't all come from academic neurosurgeons two of them were a week late but they were from people who knew me well. I applied to over 80 programs, got around 30 interview invitations (few of which were to what most here would consider tier 1 programs), and went on about 20 interviews. I liked pretty much all of the programs that I visited and felt confident that if I worked hard enough I could feel good about my training at the end of most of them.
In summary, I did a few things wrong probably, but worked hard and did the best I could with what I had. My school was supportive, but didn't really know how to advise me since they rarely match anybody into neurosurgery. I feel incredibly honored to have matched where I did, and I can't wait to spend the rest of my life in neurosurgery regardless of 'tier'.
Thanks so much. This is incredibly helpful. When I look at programs, what is the call volume and number of attending I should be targeting for those so called tier 2 programs?
FYI, I am a MS2, and has been working hard since day 1. Studied very hard for Step 1 but don’t think I will get the amazing 250+/260 like most I have seen here. I am hoping I can get my goal score of 240+. Waiting for results in a couple of weeks and also starting rotations in May.
(03-20-2018, 06:58 PM)Guest Wrote: First, there doesn't seem to be consensus at all on what the 'tiers' are. There are several incredibly strong programs that are well known for turning out amazing and politically connected surgeons. You probably won't find agreement here about some of those, but most agree that a few are on that list. Maybe that is what you can call 'academic' programs or tier 1. They are incredible and when people want to find a way to talk trash about them they usually say something like they spend too much time in the lab and not enough time in the OR. Some of that is probably jealousy because they are fancy and some may be true of some of them.
There seem to be a lot of programs that turn out really great surgeons who operate independently and well but who may be somewhat less connected and less capable of name dropping. Maybe those are the more 'clinical' programs and are what people mean when they say tier 2. This is where strong applicants who come from less well-known programs will probably end up, but there are awesome underdog stories of surprising and probably well deserved exceptions to this.
Then there are a few programs that have lower call volume and fewer attendings. I don't think a program that can't provide the minimum numbers would survive, but one sees places where the operative volume and diversity are just lower. I imagine you can still come out of those places operating well, but you'll probably never be the program director at some fancy place if you train in those programs. Perhaps that is tier 3 if we want to call it that.
All of the above can and will be argued and you'll hear incredibly different thoughts from different people on these things. Some of that will be well intended, some will be based on jealously, some will be based on arrogance, and some will be just plain trolling. In the end ignore it all, work hard, apply broadly, and again manage your expectations and remember that if you work hard enough you get to train to operate on the thing that makes humans human.
I got mostly As in the basic science years, mostly honors in clinical rotations, and solid but not amazing score on step 1 and 2. I sought out local neurosurgeons who let me rotate with them, and one who involved me in his research. A lot of that was on my own time and out of my own pocket, to include travel to work on his research projects. I had published a couple of case reports in third year. I took what probably amounted to bad advice about when to schedule away rotations, and since my letters didn't all come from academic neurosurgeons two of them were a week late but they were from people who knew me well. I applied to over 80 programs, got around 30 interview invitations (few of which were to what most here would consider tier 1 programs), and went on about 20 interviews. I liked pretty much all of the programs that I visited and felt confident that if I worked hard enough I could feel good about my training at the end of most of them.
In summary, I did a few things wrong probably, but worked hard and did the best I could with what I had. My school was supportive, but didn't really know how to advise me since they rarely match anybody into neurosurgery. I feel incredibly honored to have matched where I did, and I can't wait to spend the rest of my life in neurosurgery regardless of 'tier'.
That's a great description. There's no consensus, and I am happy personally to be going to a "clinical" program where I should be a good fit.
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