Introduction: The difficulty of successfully matching into neurosurgery is increasing annually for graduating medical students. Our study focuses on understanding the role of sub-internships and year(s) off as they pertain to medical students’ ability to successfully match into neurosurgery.
Methods: Anonymous electronic surveys were sent to all current neurosurgery residents at 104 programs in the U.S. The programs selected were cross-referenced with the AANS and NRMP databases. Email addresses of the residents were obtained from residency coordinators or program websites. The response rate was approximately 15% (210 responses/1400 approximate current neurosurgery residents).
Results: 210 residents from 75 programs completed the survey. 66% (137 of 210) scored >240 on the USMLE Step 1 and 58% (122 of 210) scored >240 on the USMLE Step 2. 67% (140 of 210) of the residents wanted to match where they did a sub-internship, but of this group, 46% (65 of 140) were not able to do so. 85% (179 of 210) of applicants were able to utilize a letter of recommendation from each of their sub-internships completed. Time off during or after medical school was reported by 24% (50 of 210). Of this group, 82% (41 of 50) did research and 40% (20 of 50) worked (these were not mutually exclusive). Of those who took time off, 92% (33 of 36) wanted to match to the institution at which they spent their time off; however, only 17% (6 of 35) were successfully able to do so.
Conclusions: Matching into neurosurgery is becoming increasingly competitive. Within our studied sample, the majority did not take time off during/after medical school. Of those that did take time off, many did neurosurgical research at an institution where they wished to match. However, spending a year off at an institution only allowed <20% of applicants to match there.
Patient Care: Matching into neurosurgery is becoming more and more competitive. This study shows the importance of sub-internships and time-off for medical students interested in applying to neurosurgery. This study will help medical students interested in neurosurgery make better informed decisions, increase the percentage of successful applicants into neurosurgery residency programs, and improve the quality of future neurosurgeons.
Learning Objectives: By the conclusion of this session, participants should be able to describe the role of the sub-internship and time-off experiences as it pertains to successfully matching into neurosurgery.