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Amplifying the Voice of Clinical Neuroscience
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Medical Student Neurosurgery Training Center


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1/21/2021

Overview of Neurosurgery Subspecialty and the Match Process

 
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A useful guide on what to expect in the match process, neurosurgical residency, and beyond

Neurosurgery Match Statistics:


If you are successful in the neurosurgery match process you will be part of an extremely elite group. There are currently around 85,000 medical students in the United States, with 20,000 of them being or seniors in allopathic medical school. Last years’ match had 40,000 applications, for only 37,000 positions. Within the Neurosurgery match, there are 112 training programs offering 232 available slots. Last year, there were 397 applications for these 232 available slots, and all available spots were filled. The average USMLE Step 1 score for candidates who matched in neurosurgery last year was 247. 


Match Candidates:

When looking at the students who matched into Neurosurgery last year, 211 were US allopathic graduates, 3 were US osteopathic graduates, and 18 were international medical graduates (IMG). 


Based on national statistics, the 232 students who matched into a Neurosurgery spot represent 0.7% of all applicants from the last match cycle. When looking specifically at US allopathic seniors, 1.1% matched into Neurosurgery. For the last cycle, 23% of US allopathic seniors and 75% of IMG’s who applied for a Neurosurgery residency spot were unmatched. When comparing matched to unmatched graduates, matched students had significantly higher statistics in the following categories: USMLE Step 1 scores, research experiences, publications, work experiences, volunteer experiences, and AOA membership status.


What Residency Entails:

The American Board of Neurosurgery is the board that sets the residency requirements and curriculum for neurosurgical education. Currently, Neurosurgery Residency is 84 months long (7 years), requiring 54 months of clinical neurosurgery and 3 months of basic clinical neuroscience. PGY1 year within Neurosurgery consists of 6 months of Neurosurgery and 3 months of Critical Care rotations that may be outside of neurosurgery. While this is the standard training breakdown, each program has flexibility within their curriculum. The Chief Residency year is considered to be either year 6 or year 7, based on the program of attendance. In order to begin your Chief Year, you must pass the Primary (Written) Exam. Upon completing your Chief Residency Year, you must receive a 2-sentence letter of endorsement from your program director in order to be certified to work as a neurosurgeon. Finally, you must pass the Oral Examination within 5 years of your training. Upon completion of your neurosurgery residency, you have the option to apply to and complete a subspecialty fellowship, which around 50-60% of neurosurgery graduates will do.


What do you need?

Neurosurgery is a unique conglomeration of skill sets including fine motor skills but most importantly a resistance to fatigue. Neurosurgery has a unique residency, in that Neurosurgery is the only residency allowed by the Residency Review Committee to exceed an 80-hour work week. It’s important to keep in mind the lifestyle that will come along with this and how you will adapt to those changes. Finally, it is important to have many role models to guide your path and help you along the way.


Neurosurgery Subspecialties:
Upon completion of a Neurological Surgery Residency, there is the option to complete further training in order to subspecialize. The current Neurosurgery subspecialties, as well as their descriptions and durations, are listed below. A full list of all programs can be found using this link. 
  • Cerebrovascular & Skull Base Surgery
    • 1-2 Years
    • There are currently 68 programs offering a fellowship in Cerebrovascular and Skull Base Surgery. 
  • Endovascular Surgical Neuroradiology
    • 1-2 Years
    • There are currently 80 programs offering a fellowship in Endovascular Surgery and Neuroradiology.
  • Functional Neurosurgery
    • 1 Year
    • There are currently 36 programs offering a fellowship in Functional Neurosurgery.
  • Neuro-Oncology
    • 1-3 Years
    • There are currently 33 programs offering a fellowship in Neuro-Oncology.
  • Neurotrauma and Critical Care
    • 1-2 Years
    • There are currently 34 programs offering a fellowship in Neurotrauma.
  • Pediatric Neurosurgery
    • 1 Year
    • There are currently 39 programs offering a fellowship in Pediatric Neurosurgery.
  • Spine Service
    • 1 Year
    • There are currently 75 programs offering a fellowship in Spine Surgery.
  • Disc Regeneration
    • 1-3 Years
    • There is currently 1 program offering a fellowship in Disc Regeneration.
  • Epilepsy Surgery
    • 1 Year
    • There are currently 7 programs offering a fellowship in Epilepsy Surgery.
  • Global Health
    • 1-2 Years
    • There is currently 1 program offering a fellowship in Global Health.
  • Image-Guided Neurosurgery
    • 1 Year
    • There is currently 1 program offering a fellowship in Image-Guided Neurosurgery.
  • Peripheral Nerve Surgery
    • 1 Year
    • There are currently 10 programs offering a fellowship in Peripheral Nerve Surgery.
  • Pituitary
    • 1 Year
    • There is currently 1 program offering a fellowship in Pituitary Surgery.
  • Stereotactic/Functional
    • 1 Year
    • There are currently 36 programs offering a fellowship in Stereotactic/Functional Neurosurgery.


Important Links:
Link to Seminar
Link to Match Data for US allopathic seniors (Starting on Page 108)
Link to Match Data for US osteopathic seniors (Starting on Page 118)
Link to Match Data for IMG’s (Starting on Page 147)
More information on Residency Match
Neurological Surgery Subspecialty List


Author(s):
  1. Steven L. Giannotta M.D.
  2. Matt Rosenthal
  3. Chelsea McCray, M.S.
  4. Alexander Kelly, B.S.
  5. Edwin McCray, B.S.
  6. Michael Kortz, B.S.



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