Questions You Should Ask
Back to Medical Students Home

1. How can I learn more about neurosurgery? Start by looking at online neurosurgery resources such as http://www.aans.org/medical_students/default.asp. The Neurosurgical Match Web site can help answer specific questions about the Match process. If you decide that neurosurgery interests you, try and find a neurosurgeon mentor at your medical school or at a hospital near you. Ask if you can shadow him/her in the operating room and/or clinic. Research is another great way to learn more about neurosurgery and to decide if it is right for you. Many neurosurgical residency programs consider research when selecting applicants. 2. Is it helpful to devote a period of time at a training program? How do I go about setting up an away elective? Most training programs select one to three residents each year, making the application process competitive. Spending an “elective” month at a program is a useful way to familiarize yourself with a training program, and for its neurosurgeons to get to know you. More importantly, it gives you an “inside look” at the program’s mechanics: the residents, operative experience, the faculty, and the city. Keep in mind that these rotations can count against you if you do not work hard or are not perceived as a team player. The best place to start setting up the elective is the neurosurgical residency’s Web site. Even if they do not have specific information, they should be able to provide you with contact persons you can speak with to attain more information. 3. As a medical student, when do I need to decide on a subspecialty? Do I have options if I decide late or change my mind? When you decide on a specialty is less important than choosing the right specialty for you. Keep in mind that neurosurgery is an early Match so it is important to start planning for the application process early, even if you haven’t completely decided. The advantage of the early Match is that you can still apply for the regular National Residency Match Program (NRMP) on time if you don’t match in neurosurgery or if you decide to pursue another specialty. 4. What is the “Match” and do I have to participate in it to get in to a neurosurgical residency program? All ACGME-approved neurosurgical programs participate in the Neurosurgery Match Program. In order to be equitable to both the applicants and programs, the Match is set up in such a way that applicants and programs rank each other (see Match Rules). Then, a computer algorithm pairs them based on their preferences. The process is divided into three phases: Registration and application are submitted to the San Francisco Match Program and individual applications are distributed to training programs. This happens over the summer/early fall of your fourth year of medical school. Interviews generally occur between October-January of your senior year. The Match usually occurs during the final week of January. Vacancies are generally posted on SFMatch.org following the Match, giving unmatched applicants the chance to potentially still obtain a neurosurgical residency. Details on the match algorithm and vacancies can be found on the Match Web page. 5. I am going to need letters of recommendation to get an interview for an internship and residency? Who should write them and what should they include? Try to obtain letters from people who know you best and can make constructive comments about your work ethic, intelligence, and ability to be a team player. Since academic neurosurgery is generally a small community, it is always helpful (but not required) if your letters come from neurosurgeons. 6. When I interview for an internship/residency, are there interviewing tips or advice to assure my success? Prior to the interview, make sure you update your application with any new awards, publications or other achievements that make you stand out. Also, look at the program’s Web page to find out details about its strengths, the faculty, and the residency. Most programs have a dinner the night before the interview with the neurosurgical residents Assume this is FORMAL unless told explicitly otherwise. Keep in mind that residents often play an important role in the selection process, so treat the pre-interview dinner as a warm up for the interview. Also, remember that these residents could potentially be your colleagues for the next seven years! On the interview day, try to arrive early. Bring a professional briefcase or folder with copies of your resume in case your interviewer asks you specifics. Know your application well and be prepared to talk about your research, your interests outside of neurosurgery, why you decided to choose neurosurgery, and why you believe you will fit in at that program. Have some questions to ask the interviewer. Finally, if you really like a program, don’t be afraid to state that. 7. What should I do if I do not match for my first year following medical school? Set up a meeting with your medical school department chairman or program director, and go over the strengths and weaknesses of your application. Generally, there are three options for unmatched applicants: Scramble to a neurosurgical residency program with a vacancy. Do an internship year in general surgery and re-apply Do research for a respected neurosurgeon or other scientist and re-apply. There is no correct answer for choosing one option over another; it is a personal decision based on your own application. 8. What is an internship; how long is internship; why do I have to do one; and what will I be doing? For most people, internship is your first year as a doctor. You spend the year learning how to manage patients and making (simple) decisions. Most of your time is spent taking care of patients, learning procedures (i.e. central lines), and basic operative techniques. The amount of time in the operating room varies significantly between programs, but don’t expect to be there a lot. Remember, routine management of postoperative patients will be extremely important to you as a neurosurgery resident and neurosurgeon, so this is your chance to learn this thoroughly. Most neurosurgical programs have a minimum of six months of general surgery during internship where you will spend time rotating through various general and subspecialty surgical fields. The remainder of the year will be spent doing neurosurgery and/or neurology, intensive care unit, and other electives. 9. Will my internship be at the same place as my residency? How will I know if the internship and residency are linked? Each training program is different. Most programs require you to do internship with them, but this is not always the case. Check with the program before you apply. 10. Where are the U.S. neurosurgical residencies? These are located all over the country. The Web site www.sfmatch.org has a full listing, as does this Web site < insert the link to residency program table> 11. How long is a neurosurgical residency? What is the training sequence? U.S. neurosurgical residencies are between six and eight years, including internship. Typically most programs require One year of internship One to two years as a junior resident seeing consults, doing basic operative and bedside procedures One to two years of research - some programs allow you to do a fellowship during this time One year as chief resident As a more senior resident, expect to have increased autonomy in the operating room, as well as in making patient-care decisions. 12. Is there a pyramid system for residency and am I guaranteed a spot from year to year? Or, will I be in competition with other residents? Assuming you meet the individual promotion criteria for your specific training program, you will be guaranteed a spot. These criteria vary from program to program, but should be made available to you if you ask the program director. 13. Where would I find information on what I can expect my salary and insurance costs to be when I become a neurosurgeon? Many online resources list the mean salaries for neurosurgeons – try a Google search or visit http://www.salary.com. Keep in mind that posted salaries are estimates, generally based on small surveys. Remember that there is considerable variation in salaries depending on where you live, your practice (i.e. academic vs. private), and how much you operate. 14. What is Board Certification and what does it mean? American Board of Neurological Surgery certification indicates that you have passed competency exams to practice as a neurosurgeon. The vast majority of neurosurgeons are Board Certified, so it is really a minimum standard. To qualify, an applicant must complete neurosurgical training in an ACGME-approved residency (Canadian and Mexican neurosurgery programs have their own certification process). A primary written examination must be passed, and the applicant must collect patient data from his or her practice over a 12-month span. These data along with letters of recommendation and hospital privileges are needed to apply for an oral examination. This entire process must be completed within five years of finishing residency. Once the oral exam is passed, the neurosurgeon is considered “Board Certified.” It is should be noted that obtaining privileges to practice neurosurgery in a hospital does not typically require Board Certification, but the vast majority of neurosurgeons will become Board Certified during their career. 15. Is Board Certification like a license that I have to renew? Beginning in 1999, the Board began issuing time-limited certification good for 10 years. To renew Board Certification, a neurosurgeon must demonstrate that he or she is continuing to practice neurosurgery, including submitting cases, demonstrating self-learning, and passing a written exam. 16. Do other medical specialties perform the same type of medicine/surgery as neurosurgeons and is this considered competition for the same patient universe? There is some overlap between neurosurgery and other specialties (i.e. orthopedics, interventional neuroradiology, vascular surgery) but no other subspecialty is exactly the same. As a neurosurgeon, your training is in the operative treatment of disorders involving the entire nervous system, and you will always have 17. Is there a possibility of neurosurgery becoming an “extinct” specialty in the near future due to robotic surgery technology or anticipated new nonsurgical interventions? No, this new technology will get incorporated into neurosurgery, diversifying the treatment options for our patients.