Once you’re in a position to do something about it and try to convince others to make neurosurgery residency match a meritocracy, you benefit from the system the way it is and so will your colleagues. Many if not most of them would rather not fight at that point in their career. You’ll see that the structure that keeps you in a position of power as a neurosurgeon doesn’t want these things to change, either.
Also, you forget something huge here: what measures would you use to make a meritocracy? What happens in ties between applicants if your scale isn’t granular enough? Are we eliminating letters? Who decides what matters?
Not only would meritocracy never exist if it were possible, talking about it is irrelevant since we probably won’t agree on what it looks like.
Ok smart guys, if match to residency is supposed to be meritocracy what would the criteria be? Number of publications which is biased based on academic proclivity of your faculty? Grades which is biased based on your school, if they even have grades or class rank, which is increasingly being phased out? Step 1 scores which are now pass/fail? Step 2 scores - a lot to put on a single exam which may be prone to bias based on socioeconomic background and degree too which school emphasized preparation for the test? Letters of recommendation which are completely subjective and based on a one month audition? Please inform us all of how to eliminate this conspiracy amongst neurosurgery residency programs…
Outrageous sentiment.
Bring back step 1 scores.
The medical establishment is conspiring to create a corrupt system to benefit themselves and their offspring.
The applicant who is great surgically and has a ton of pubs but tests poorly on endocrine and derm may take issue with that.
Step 1 isn’t coming back the way it was.
Are you trying for a more equitable system? It sounds like you are trying for a system where you have the advantage rather than the current system where you have less of one.
For what it's worth I turned down a top 10 med school for a mid-tier school and a full ride. The school I chose did have a home department so that was not much of an issue. I will say from being in on interviews not having a home department does hurt you. You lack early access to the field, shadowing, OR experience, research is harder to come by, it's harder to develop strong mentors who will advocate for you etc. If any attending has friends, or personal experience at your institution they will make calls/texts and ask about you if you have a home program. You'll miss out on a lot of these opportunities if you don't have a home program.
At the end of the day, I think a lot of it depends on how set you are on neurosurgery and if you are willing to take that risk and pivot if needed. I have friends who dual applied and ended up in fields like EM etc and they have already finished training and are living their best lives which would only be better with no med school debt.
If you are seriously considering neurosurgery, and you have acceptances to multiple medical schools, I do not think you can in good conscience consider going to a medical school that lacks a home department. I don't think the discussion is honestly any more complicated than that.
omg. take the full ride. no debate
