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IMG Residency Match Forum International Medical Graduates (IMGs) discussing the residency matching process.


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  #1  
Old 06-08-2014
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Question Neurosurgery after Neurology

Hello doctors!

I'm a fresh medical graduate from St. Luke's Medical Center here in the Philippines who aspires to be a neurosurgeon. Given the low probability of being matched, do you think it's a good idea to just apply for Neurology residency (more IMG friendly), get matched, finish the training, impress the Neurosurgery department in the process, then reapply as a neurosurgery resident? Basically I'll be doing two residencies.

Your reactions and opinions are deeply appreciated! Thank you!
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Old 06-08-2014
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Or is it better to take up General Surgery residency then take up Neurosurgery residency afterwards?
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Old 06-08-2014
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There was a guy from my school with a similar plan, he did a few electives in neurosurgery back in 2007/2008, than got a research position at MGH's Neurology and after 4 years, he ended up applying to Neurology and Psych to end up in Psych.. He's happy now, he got married and had kids, and he's in a great psych program, but this path was entirely different from what he had imagined..

Once, I thought that it would be wise to do internal medicine residency first and than apply to ophthalmology, as a friend of mine once did.. But I ended up falling in love for Critical Care Medicine and I couldn't dislike ophtho more..

Similarly, I watched a truly inspiring lecture once by Dr. Ben Carson who told the audience that he wanted to be a psychiatrist but he realized he got excellent hand-eye coordination during a neurosurgical rotation and ended up getting a mentor that guided him through his path as a brilliant neurosurgeon..

What I'm trying to say is that it's not easy to change specialties, because you simply end up changing your mind over time, start liking your new path and eventually losing your drive to get out of your comfort zone..

If you're really that passionate about neurosurg, I suggest you to stop thinking about how hard it is to get a position in US and to stop trying to find back up plans.. Instead, I would suggest you, considering you're still young, to sit for Step1 first and try to get stellar scores, than to find a real mentor in the field at top places to work as a research fellow for a couple of years, get some pubs, to finally apply directly for neurosurgery/surg transitional.. This path is herculeous, and if you don't have guts to deal with uncertainty, than forget about neurosurg, neurosurg in the US is not for you at all.. Better to apply for clinical neuro..

The guys I heard of or have briefly met who are IMGs that ended up in neurosurg. completed residency in their home countries plus a few years of very productive research in places like hopkins/harvard/ccf and than applied to neurosurg. in US, I, myself, truly admire those guys and I would easily give up if I were one of them.. If you're one of these guys, good luck my friend!

Last edited by cearamor; 06-08-2014 at 11:34 PM.
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Old 06-09-2014
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Thanks for the reply!

My problem is not really about having the guts to face uncertainty, but rather, having the resources to face uncertainty.

My parents can only afford one year of application hence I am thinking of taking up Neurology (higher chances of being matched) instead of Neurosurgery. This will allow me to save up so that after my training, I can reapply as a Neurosurgery resident using the money I saved.

I am leaning more on Neurology rather than General Surgery because I know that Neurology and Neurosurgery departments work hand-in-hand and I am hoping that I can impress the Neurosurgery PD with my work so that he/she will accept my application after my Neurology residency training.

Am I nuts or what?
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Old 06-09-2014
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iF money is the problem that causes this uncertainty, i suggest you follow the path with neurology...but just think if you like neurology, it's everyday practice, because you may end up with thiis residency. Moreover, i think the whole experience with usmle studying, the application procedure, immigration to a new country...all these will be pretty new and exhausting...if after all that you still have the courage to think of neurosurgery, then you must really want it...
You may now think that you give up your dreams, but a mature person thinks of all the odds, what he has in his hands(money for example...) and i think you are really mature thinking of your family...
What if you think another specialty in general that you may like more....for example, critical care medicine that is more practical...because neurology may have to do with nervous system, but it's EEXTREMELY different from neurosurgery...
I would also suggest you have a rotation in the US in neurosurgery clinic and to a 2nd choice specialty clinic...maybe life as a neurosurgeon is not what you want...
It is nice to have dreams...So, either stick to a specific plan about neurosurgery and not other specialty or choose another one that may be your 2nd choice but you really LIKE IT...good luck...
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Old 06-09-2014
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Thank you for your opinion!

Our dean always tells me "If you want to be a good neurosurgeon, you have to be very good in neurology".

I think taking Neurology as a residency will not only provide me with finances for Neurosurgery application later on, but will also give me the necessary knowledge in Neurology and the connections that can increase my chances in matching in Neurosurgery. If ever I do not get matched in Neurosurgery, I can always apply for fellowship, maybe in Neurocritical Care.
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Old 06-09-2014
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Also, bear in mind that you MUST get a residency that sponsor you a H1b visa! Changing specialties with J1 is a pain in the neck and there are several restrictions to it.. So forget about neurosurgery, at least for now, and start building your application geared towards clinical neuro.. I participated in this year match for categorical IM, but met some IMG friends applying for Neuro and Psych and I have to tell you.. Neuro and Psych are becoming popular among AMGs and consequently getting really tough to get into, especially Univ-based programs! So don't be fooled thinking that sitting still will garantee you a great neuro program. You'd better build a top notch application with USCE, US LORs, scores above 230 and pubs!
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Old 06-09-2014
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Of course there's no guarantee in anything. ^_^ I'm a fresh graduate so I have no USCE or US LoR... I'll be using my USMLE scores as my weapon for employment.
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Old 11-25-2014
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Go to neurology - Then Endovascular surgical neuro-radiology (ESN) as a fellowship.
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Old 11-25-2014
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That's an absolutely good idea! I was thinking about interventional neuroradiology as an alternative a long time ago and now that you mentioned it, I think it's a great if not better idea than neurosurgery! Thanks!
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Old 11-25-2014
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Thanks for sharing the advices.
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Old 11-27-2014
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To do interventional neurology you will have to go through vascular neurology first. Keep in mind there are radiologist who finish their training and do 1 year in neuroradiology and then 1 year in neurointervention. As for what goes to which one will supersede the other, so far Endovascular Surgical Neuroradiology is dominated by Radiologists.
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