Acceptance Factors for Matching into a Neurology Residency

Caleb McEntire, MD
  • Sep 21
  • 11 min

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From A Program Director Viewpoint: What You Need to Match into Neurology Residency

 

The NRMP conducted a survey to determine what factors Program Directors consider when deciding which candidates to interview and rank for their residency program. The results were compiled into a “at a glance” tool, which is extremely helpful in gauging where your application packet stands compared to the applicant pool, and whether adding additional components, like a letter of recommendation (LOR) in the specialty, could give you a leg up as programs review your application.

The interactive tableau tool can be found here, and we recommend taking a look at the specialty you’ll be applying to before submitting your ERAS packet: https://public.tableau.com/profile/national.resident.matching.program#!/vizhome/PDSurvey_0/Desktoptablet

 

For neurology specifically, major components of the survey you should pay attention to include: (from top to bottom of the page):

 

  • Selection Criteria for an Interview Having an appropriate Step 1 or COMLEX score in neurology is an important factor, but the good news is that your goals for these do not have to be in the egregiously high range that specialties like dermatology and neurosurgery expect! As we’ll detail below, getting a Step score of >220 is just fine in most cases, and even below that is not a problem as long as you apply more broadly! After this, having good grades in the neurology clerkship is key..

 

  • Step 1 and Step 2 Scores:

  • Step 1 – Score
      • 240+ is a very solid score in neurology, with the median being 230.
      • Range programs do NOT typically offer interviews: 200-220 seems to be the minimum threshold we would recommend for having a good chance at enough interviews. If you’re below this range, we suggest having a back-up specialty you could consider.
      • Range programs DO typically offer interviews: 230+ seems to be the range at which you can feel comfortable in being offered interviews by a decent number of programs. If you’re in the 240+ range, you can likely be selective about where you apply.

 

  • Step 2CK – Score
      • 200-220 seems to be the minimum threshold at which programs will grant interviews
      • Scores below 200 generally will place you in a unfavorable position to receive an interview 

 

  • Step 2CK – Timing of Taking the Exam
  • Only 25% of programs required at least passing CK, while 42% did require the test at all. We do expect this number to grow, but for now we recommend timing your CK on a case-by-case basis; in many cases we would recommend taking it before you’ve submitted ERAS, but depending on where you’re applying you could be perfectly fine waiting until later.

 

  • Failing Step 1 is moderately likely to be a show stopper: 
    • Failing Step 1 is a BIG deal in ANY specialty, but luckily this is not as pivotal in neurology as in some specialties like neurosurgery or dermatology. 27% of neurology programs will NOT consider you if you’ve failed Step 1, and 36% will NOT consider you if you’ve failed Step 2 CK. So, if you’ve failed an exam, you can still apply, but you should apply to a BIG number (50+) of programs. 59% and 58% of programs seldom consider applicants who have failed Step 1 and Step 2, respectively.

  • Types of Applicants Considered:
    • International Grads (U.S. and non-U.S.) will not face significant barriers matching into neurology in most cases: 53% of US programs often interview US IMGs, while 47% often interview non-US IMGs. Only a scant 8% and 5% report never interviewing US and non-US IMGs, respectively! While this factor may lower how competitive your application is in a few cases, it is not prohibitive for this field.
    • Osteopathic graduates have a good chance to match into neurology: Only 16% of programs will never interview DO applicants, and only 19% never rank them. Over 60% of US neurology programs report interviewing DO applicants often. For the 21% of programs that seldom interview DO applicants, it is worth doing your research to identify these programs so that you can best increase your chances of matching.

  • Interviewees Get Ranked!: If you get an interview invitation, you are very likely to end up on the rank list if you interview. We recommend ranking about 8-12 programs depending on how competitive you are, so once you receive this many interview invitations, you can feel okay with starting to prioritize and cancel as more come in given you are likely to get ranked.
  • Expect to receive most interview invitations by October: 48% of the interview invitations will be sent out during October, with September tailing closely at 31%. If you haven’t heard from neurology programs by the end of October you do still have a chance to hear from them, but this is the most common timeframe.
  • Expect to interview in November/December: A combined 68% of interviews happen starting in November, which gives you ample time to prepare for your interviews. For further discussion on how to prep for your interview, see our blog post on How to Crush your Residency Interview.

 

After you’ve browsed your specialty, take a look at a few other specialties and note what’s NOT important for neurology:

    • Step 2 CK isn’t particularly important in neurology
  • The MSPE/Dean’s letter isn’t particularly important for neurology
  • Your personal statement isn’t as important in neurology as in other specialties

 

Summary for Neurology Applications:

  • A solid neurology application would include a 230+ on Step 1, 220+ on Step 2, a LOR from 1-3 neurologists as well as one LOR from medicine, and good grades in your neurology clerkship
  • Neurology is more IMG and DO friendly than many of the specialties! If you’re an IMG or completing a DO program you can still be a competitive applicant in this field.
  • If you’ve failed an exam, you can still apply in neurology, but you should apply more broadly than you would otherwise and may want to apply for a back-up specialty.
  • Expect Interviews in November-December. Reach out to programs you have high interest in if you haven’t heard from them by mid-October. Once you have about 10 interview invitations, you can consider being a bit more selective about which ones you actually take (but not before).

Good Luck! ☺ 

Wondering about your chances of matching into other specialties for residency? Check out our analysis of the NRMP directors survey “at a glance” tool for areas including anesthesia, dermatology, family medicine, transitional year, psychiatry, emergency medicine, and more under the Residency Applications category of our blog! If you need further or specialized assistance understanding which residency specialties you are best suited to apply to, you can contact us or visit our residency advising page to learn more about how Elite Medical Prep residency advising services.