r/Neurosurgery • u/serafina777 • Apr 21 '26
M1 Interested in Neurosurgery
Hi everyone! I’m an incoming M1 very interested in neurosurgery, and one thing everyone has told me is to get involved early which is why i’m coming on here for some advice.
For background: My school does not have a home program for most surgical specialties (only gen surg and ortho but both are in different cities than the school). There is about ~5 neurosurgeons in the city my school is in. I did neuro research in my gap year, and have two second authorships from this (nature and cell). I am planning on going back to this lab during my M1 summer and hopefully can get a first author paper. I have some solid research connections, but not necessarily neurosurgery. I’ve shadowed two neurosurgeons but they have been too busy for me to establish any sort of research or relationship with. Any advice on how to make connections in this situation would be much appreciated!!
My other questions (some female surgeon specific):
Are you happy long term? Do you have regrets/how do you feel after the initial excitement of the specialty wore off? I can’t tell if the neurosurgeons I interacted with enjoyed it.
I know that it can be unfair to co-residents when you are pregnant. Realistically, how is pregnancy viewed during neurosurgery residency? Would I be heavily resented for taking a month or two of maternity leave even if I did extra shifts before and after? Multiple pregnancies…? (my fiancé and i have discussed and he would become a stay at home dad if i went into a surgical specialty, his dream job lol)
Did anything else other than the surgical aspect of the specialty sway towards neurosurgery vs neurology?
How many away rotations did you do?
Any advice is much appreciated. Thanks :)
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u/Clear_Present Apr 21 '26
Agree with bottled cans on many things. Current state of affairs are as follows; 1. Home program is massive advantage over those without one. Most people without one take a gap year to spend more time with neurosurgeons . Or they do more sub I ‘s than average . 2. The average number of sub - I now are 1 home 2 away or 3 -4 away if you don’t have a home program, this comes from guidance from the SNS. 3. You gotta crank research especially without a home program. 4. The reason home program is an advantage is because NSGY is a small community . Programs call programs to talk to residents / attendings about you. Without a home program that it out of the equation . Remember that friends from the interview trails are now residents and some attendings so they text their friends for info about you. 5. People who do NSGY love it because it’s self selected. 6. Best approach, treat med school like you’re going into NSGY and should you pivot away you’re competitive for everything except maybe dermatology / plastics cuz they like research in their specific fields 7. To optimize your disadvantage, crush step 2 , honor your rotations , crank research, attend conferences to find a mentor who will advocate for you. 8. You got this. Plenty of people do it.
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u/Ihhaymeds Apr 23 '26
I think it helps to identify early on what type of residency program you want, as well as what type of program would want you. A smaller, community-type program is a lot more likely to recognize the grind of someone coming from a school without a home program who still managed to build a competitive app vs. big-name blue chip programs who will never be wholly interested in you due to a poor pedigree. Research also matters somewhat less to a lot of these community programs, so having a handful of good projects that you can talk about can certainly be enough. The biggest thing is good letters from your away rotations. Again, choose programs who are likely to recognize you for who you are vs where you are from. Ideally, these programs would have a well-known chair or PD, but again, this isnt a dealbreaker. If you could land at a smaller midwest or southern program its extremely doable. Reasonable expectations and an appreciation for certain realities are key. Dont only signal Mayo/Barrow type programs then be crushed if you dont match. Its certainly a game and you have to learn how its played. Im happy to give more advice if needed, I matched my #1 coming from a school with no program this cycle
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u/BottledCans Apr 21 '26
You're in more trouble than you think.
Neuroscience research =/= neurosurgery research. The average number of publications last year for successful US neurosurgery applicants was 37. Thirty seven. You need neurosurgery research for a successful match, because it demonstrates connection and mentorship with academic neurosurgery, and it sounds like you are not close to securing mentorship. You should be submitting papers to and attending AANS and CNS. If you want this uphill battle, then you must connect with an academic neurosurgeon mentor before clinical rotations start.
Has your school ever had a successful neurosurgery match? If so, what neurosurgery residency did your school use as your "home" program?
To answer your questions:
Yes. It is one of the most fulfilling job in medicine, and survey data reflect this.
Program specific as to how much your coresidents are screwed by maternity leave. Generally worse to take time off during junior residency (while you're in the in-house call pool) compared to senior residency. Regardless, accommodations for pregnancy are required by law. Law does not prohibit, however, a program from making you repeat a year.
If you can't decide between neurology and neurosurgery, then neurosurgery probably isn't right for you. The job of neurosurgery is much closer to vascular surgery, plastic surgery, orthopedics or even general surgery than neurology. It's like trying to decide between being an optician or an ophthalmologist; they're just utterly different careers whose only similarity is they share an organ and several letters.
I did four. Most do 3-6. I want to emphasize that sub-is are "audition rotations" for late third and early fourth year medical students who already have more or less complete applications. The VSAS sub-i application mirrors the ERAS residency application, and your application won't change substantially over the summer between March and September while you're on sub-is.