Step 1: Explore the Specialty
Before you pursue a career in Neurosurgery, it's important to be well informed about the specialty. We've put together a great collection of articles and resources which are essential reading for the aspiring neurosurgeon.
These articles will give you a better idea of the pros and cons of a career in the field, trends in the specialty, and hot-topic issues for trainees.
Step 2: Review Neurosurgery Match Data
Neurological surgery is a highly competitive specialty. In a study comparing NRMP data for applicants from 2009 to 2022, researchers found an increase in Step scores and mean number of research experiences; abstracts, presentations, and publications; and work and volunteer experiences.
In the 2024 match, 31.3% of US MD seniors failed to match, meaning that close to ⅓ failed to match. The numbers are significantly worse for osteopathic and international medical graduate applicants.
Neurosurgery-Charting Outcomes in the Match for U.S. MD 2024
Charting Outcomes™: Characteristics of U.S. MD Seniors Who Matched to Their Preferred Specialty: 2024 Main Residency Match®
Neurosurgery-Charting Outcomes in the Match for U.S. DO 2024
Charting Outcomes™: Characteristics of U.S. DO Seniors Who Matched to Their Preferred Specialty: 2024 Main Residency Match®
Neurosurgery-Charting Outcomes in the Match for IMGs 2024
Charting Outcomes™: Characteristics of International Medical Graduates Who Matched to Their Preferred Specialty: 2024 Main Residency Match®
Step 3: Understand Residency Selection Criteria
"Our program is very competitive, and we receive applications from many of the top medical students in the country," writes the Department of Neurosurgery at the University of Utah. "For the 2024 match, we received over 300 applications and interviewed 30 candidates for our three positions."
To maximize your chances of matching with your first-choice residency program in neurosurgery, you must become well informed as early as possible. In particular, you need to know the criteria residency programs use to select residents.
We recommend beginning with the following resources:
Neurosurgery-2024 NRMP Program Director Survey
Charting Outcomes™: Program Director Survey Results, 2024 Main Residency Match®
Check out these other recommended resources
Step 4: Develop your Strategy for Success
The process of matching into the specialty and/or program of your choice begins well before it’s time to work on the residency application. Success is the culmination of many decisions and actions that take place over a period of several years.
Many medical students struggle to become strong residency applicants not because they are not talented or hardworking, but because they lack knowledge or guidance about the actions they should take to position themselves for future success.
Complicating matters even further is the rapidly changing landscape in residency admissions making it difficult for both residency applicants and mentors to stay well informed. A recent study showed that 75% of faculty advisors had advising concerns due to lack of knowledge of current practices or recent changes to the residency application.
As competition for positions in the neurosurgery residency match intensifies, it's more important than ever to be an informed candidate who has the "right" strategy for success. To develop the optimal strategy, use our book, The Successful Match. It's been designated recommended or required reading by the Association of American Medical Colleges, American Medical Women's Association, and numerous allopathic and osteopathic medical schools.
AMSA wrote the book "provides the medical student reader with detailed preparation for the matching process." Fully updated in 2025 with over 1,000 pages of powerful information, the book is a must-have resource to help you stand out from the competition.
This book will empower you to become a stronger neurosurgery residency applicant. Inside, you'll find answers to the following questions and much more:
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What are letter writers asked to write about in the standardized letter of recommendation and how can you ensure that a meaningful letter is written on your behalf?
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What strategies should you consider in making your away rotation decisions?
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What should your signaling strategy be in neurosurgery?
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Step 5: Make the Most of your Preclinical Years
Step 6: Apply for Scholarships and Awards
Winning medical school scholarships and awards can provide a major boost to your residency application, and set you apart from your peers. Awards can be placed in the application, MSPE (Dean's Letter), letters of recommendation, and CV. We have found that interviewers often ask about awards during residency interviews.
Step 7: Assess your USMLE Step 1 Score or COMLEX 1 Score
Step 8: Strive for Success During Clerkships, Observerships and Externships
Grades in required or core clerkships are very important to neurosurgery residency programs. In a NRMP survey of neurosurgery residency programs, 76% cited "grades in required clerkships" as a factor in selecting applicants to interview. Neurosurgery rotations are also of obvious importance to international medical graduates seeking positions in the field.
Step 9: Prepare a Powerful Residency Application
Step 10: Develop a Powerful Personal Statement
Step 11: Deliver an Impressive Interview Performance
What if I didn't match?
If you were unsuccessful during your initial match cycle, you'll need to sit down with your dean or advisor to review your match strategy. In planning your reapplication, each of the steps above becomes even more important.
For those who seek additional expert assistance, we can provide that. Dr. Desai has had significant experience in helping re-applicants match successfully.
This is provided via a Strategy for Success Session. Dr. Desai will perform a comprehensive review of your credentials, assess your strengths and weaknesses, and provide you with a specific plan to implement tailored to your unique situation.