Frequently Asked Questions by MS1s and MS2s
Neurosurgery is one of the most competitive surgical subspecialties. A very strong performance on Step I of the USMLE is essential to be competitive. Programs are most interested in students who have demonstrated a strong interest and commitment to the field through clinical exposure and research. Work with and develop a relationship with the local Neurosurgical practice. Review the websites of professional organizations. Work with your senior medical students and recent alumni in Neurosurgery residency.
Neurosurgery is a very competitive specialty and while research experience is not required it would certainly strengthen your application. Most importantly do a research project that you find highly interesting and are eager to engage with. Your preclinical years are a great time to get started with a research project. It is generally preferable to have completed one or two comprehensive projects where you had significant involvement rather than multiple projects where you were only minimally involved.
Talk to your mentors and Dr. McEchron as he can help guide you to find a good “fit” depending on your interests. Work with your peers, recent graduates, Residents and Fellows as well as NSG faculty and express your interest in getting involved.
A strong academic foundation and strong performance on Step I is your most important priority. If you can successfully add volunteer work or other extracurricular activities and maintain a healthy balance with your academics then it is highly recommended. Volunteering will make you more well-rounded and better informed to make a career decision while gaining valuable experience and serving the local community.
Frequently Asked Questions by MS3s and MS4s
Most students start thinking about letters toward the end of 3rd year and beginning of 4th year. We recommend doing your Surgery Sub-Internship and away rotations early in Blocks 1-5 of your 4th year to facilitate developing professional relationships and obtaining letters of recommendation along the way. Your Career Advisor and Specialty Advisor can provide you a more specific recommendation of the number and type of letters based upon your individual circumstances and competitiveness.
You should have your CV updated and your personal statement available for reference. If you are asking for a LOR during your Sub-I or away rotation, consider asking for it about three weeks into the rotation from a faculty member who you have worked very well with. Even better if you have developed that relationship with the Department Chair or Program Director. When asking for a Letter of Recommendation it is ideal to do it in person. It is appropriate to ask specifically if they would be willing to write you a “strong letter of recommendation”. Please thank you letter writers for their effort.
You are allowed to submit up to 4 letters in ERAS. We recommend including letters from faculty that know you well from your Sub-I and away rotations and from faculty that support other aspects of your application. This could include your SP mentor, MPH or Certificate of Distinction programs you are a part of and from a research mentor you have worked closely with.
Yes, depending on specialty, all LORs do not have to be from the field you are applying to residency in. It is recommended that most of your letters come from Neurosurgical attendings with whom you worked with during your rotations. A good combination of letters might be: Department Chair, two attendings, and one research mentor (if you worked closely together and have a good working relationship). That said, only ask people who are willing to write you a strong recommendation!
A Department Chair Letter may be required for some NSG programs. Please check the individual program websites for more specific expectations.
In addition to your 4th year Surgery Sub-I rotation, away rotations in Neurosurgery are strongly recommended. Some of the benefits of doing an away rotation include networking, increasing the number of interview invitations you’re likely to receive, and figuring out what you’re looking for in a residency program. Neurosurgery is a small community and many Department Chairs and Program Directors know each other and having an endorsement from faculty from your away rotations can make a very positive impact on your application. We recommend working closely with your Career Advisor and Specialty Advisor to help with this decision.
Information Specific for Neurosurgery
Neurosurgery is one of the most competitive residencies currently. Typically, the residency is 7 years. Both categorical and advanced positions are available. There are over 100 Neurosurgery training programs in the U.S. The residency often involves dedicated years of research in Neurosurgery. Neurosurgical training typically involves rotations and immersion in cerebrovascular disorders, brain tumors, epilepsy, neurotrauma, movement disorders, pediatric neurologic disorders, neurocritical care, peripheral pain, radiosurgery, and spinal disorders. Training programs typically offer 1-3 positions/year. For medical students, Step 1 scores typically are quite high, and research activity should be robust. A career as a neurosurgeon is challenging and fulfilling.