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How to Match into Neurology in 2023

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by Mohamed Ahmed in How to Match

Are you wondering how to match into neurology? Or how many neurology residency programs are there? Do you want to know everything there is about neurology residency interviews? Need to know how many interviews to match in neurology?

In this article, you’ll learn everything you need to match into neurology.

Summary:

  • Neurology is less competitive, in part due to having a low % of unmatched US seniors.
  • In part due to the volume of applications, neurology residency programs use standardized screens to “weed out” applicants.
  • The most successful applicants won’t fail any USMLE, have good USMLE scores, a stellar MSPE, and have high grades in required clerkships.
  • Historically, most neurology interview invites occur before October 31, and the vast majority before December 31.

Table of Contents

How Competitive is it to Match into Neurology?

How competitive is it to match into neurology in the US? Here we have the unmatched % for US seniors by specialty. The “Unmatched %” means the % of US seniors who applied into neurology who did not match during the given year.

This is one measure of specialty competitiveness – perhaps the most relevant if you want to match into neurology.

For more on the competitiveness of neurology relative to other medical specialties, see this article.

How Many Neurology Residency Programs Are There?

Before we discuss how many neurology residency programs there are in the US, let’s review some terminology. For many specialized residency programs (e.g., neurology, dermatology, radiology, radiation oncology, etc.), the specialty training begins during their second year of residency. This second year is also known as the PGY-2 (post-graduate year 2, for the second year after graduating from medical school).

Categorical vs. Advanced vs. Physician Neurology Programs

Neurology has three different kinds of residency programs applicants can potentially enter: categorical, advanced, and physician (R).

Categorical refers to programs that include all years of residency training. Neurology residency lasts four years. The first year of training, however, is a “preliminary” year that can be either internal medicine, surgery, or transitional (a sort of grab-bag that will depend on the hospital). Some programs include the PGY-1 “intern” year – these programs are known as “categorical” programs.

Others, however, require applicants to match separately into an intern year. These programs, which begin in the PGY-2 years, are referred to as “advanced” positions.

Finally, for others who have already completed at least a year of residency training, they may be eligible for a “physician” neurology position. These positions allow applicants to move directly into the PGY-2 specialty training and skip the PGY-1 year. This arrangement may be ideal for those who want to complete residency sooner and not have to repeat their intern year.

How Many Neurology Residency Programs and Positions Are There?

In the 2022 NRMP Match, there were:

  • 139 Neurology programs offering 772 PGY-1 (categorical) positions,
  • 42 Neurology programs offering 233 PGY-2 (advanced) positions, and
  • 8 Neurology programs offering 9 Physician (R) positions

Thus, the total number of Neurology residency positions in 2022 was 772 + 233 + 9 = 1,014. There were at least 139 Neurology programs in 2022. However, it is unclear how many more than that there were since many of the residency programs that offer advanced and/or physician positions also offer categorical ones.

See the 2022 Main Residency Match Results and Data for more information on neurology match statistics.

How to Match into Neurology: Impressing Program Directors

To match into neurology, you must first be invited to interview. According to the most recent program director (PD) survey from 2021, PDs shared what they look for in candidates they hope to interview.

For neurology, the top five most important characteristics for receiving an interview, according to program directors, were:

  • USMLE Step 1 Score
  • MSPE
  • USMLE Step 2 CK Score
  • Grades in Required Clerkships
  • Any Failed USMLE Attempt

Note that with Step 1 moving to pass-fail, Step 2 CK will almost assuredly take on greater importance for matching into neurology in the future.

The same data are presented more fully in a table. Here you will see the % of program director respondents who cited a factor as important for granting an interview, as well as the mean importance score (out of 5).

To balance the breadth of program directors citing each factor with the importance given to each factor, a “composite score” was created. This composite score takes the average of the % respondents citing a factor with the importance score scaled to 100%. For example, if 80% of PDs cited a given factor, with a mean importance score of 5.0 (out of 5), the composite score would be 90%. (The average of 80% of PDs citing with 5/5 – or 100% – for the mean importance, for a composite score of 90%).

Neurology: Characteristics Considered in Deciding Whom to INTERVIEW (% of Respondents Endorsing)Neurology: Characteristics Considered
in Deciding Whom to INTERVIEW (Mean Importance / 5)
Neurology: Characteristics Considered for Interview Composite Score (Average of % Respondents Endorsing and Mean Importance / 5)
USMLE Step 1 Score96.6%3.791.6%
MSPE93.1%4.589.6%
USMLE Step 2 CK Score89.7%3.888.6%
Grades in Required Clerkships72.4%3.985.7%
Any Failed USMLE Attempt82.8%4.485.4%
Class Ranking/Quartile75.9%4.185.3%
Grades in Clerkship in Preferred Specialty75.9%3.982.9%
Any Failed COMLEX-USA Attempt69.0%4.482.1%
Consistency of Grades65.5%4.279.0%
COMLEX-USA Level 1 score69.0%3.779.0%
Awards/Honors in Clinical Clerkships62.1%3.578.7%
COMLEX-USA Level 2 CE Score65.5%3.778.5%
AOA Membership58.6%3.877.2%
GHHS Membership65.5%3.977.0%
Passing USMLE Step 2 CS65.5%3.876.0%
Awards/Honors, Clerkship in Preferred Specialty72.4%3.775.2%
Continuous Medical Education w/o Gaps58.6%3.474.8%
Medical School Accreditation Status44.8%474.2%
Medical School Reputation31.0%4.173.8%
Passing COMLEX-USA Level 2 PE3.773.5%
Awards/Honors in Basic Sciences31.0%2.973.2%
Sigma Sigma Phi Membership31.0%471.8%
USMLE Step 3 Score27.6%3.471.5%
COMLEX-USA Level 3 Score24.1%3.670.8%
How Medical School Handled Virtual Rotations10.3%469.8%
Letters of Recommendation in Specialty93.1%4.268.4%
Personal Statement (Overall)86.2%3.967.3%
Diversity Characteristics75.9%3.866.1%
Perceived Commitment to Specialty93.1%4.363.3%
Having Overcome Significant Obstacles79.3%3.962.4%
Professionalism and Ethics79.3%4.657.7%
Perceived Interest in Program65.5%4.157.3%
Leadership Qualities75.9%4.156.5%
Volunteer/Extracurricular Experience72.4%3.855.5%
Personal Prior Knowledge of Applicant72.4%4.154.3%
Other Life Experience69.0%3.953.0%
Audition Elective/Rotation in PD's Dept34.5%452.3%
Involvement and Interest in Research41.4%3.752.1%
Ability to Work Legally w/o Visa34.5%3.548.1%
Visa Status24.1%447.8%
Fluency in Language of Pt Population37.9%3.446.1%
NRMP Flag for Match Violation44.8%4.645.2%
Interest in Academic Career34.5%3.744.5%
Away Rotation in Specialty Elsewhere24.1%3.437.0%

Here are the composite scores for the criteria neurology program directors use for grading interviews.

What Do Neurology Program Directors Look for When Ranking Applicants?

Getting an interview is only part of the process of matching into neurology. Program directors also rank the most important factors for creating their rank order list.

In the 2021 Program Director Survey, neurology PDs rated these criteria as most important for deciding whom to rank:

  • USMLE Step 1 Score
  • MSPE
  • USMLE Step 2 CK Score
  • Class Ranking/Quartile
  • Any Failed USMLE Attempt

We can see the full list here:

Neurology: Characteristics Considered in Deciding Whom to RANK (% of Respondents Endorsing)Neurology: Characteristics Considered
in Deciding Whom to RANK (Mean Importance / 5)
Neurology: Characteristics Considered for Rank Composite Score (Average of % Respondents Endorsing and Mean Importance / 5)
USMLE Step 1 Score79.3%3.794.6%
MSPE82.8%4.493.9%
USMLE Step 2 CK Score72.4%3.791.1%
Class Ranking/Quartile69.0%4.189.1%
Any Failed USMLE Attempt58.6%4.686.7%
Grades in Required Clerkships55.2%4.186.4%
COMLEX-USA Level 2 CE Score51.7%3.785.4%
COMLEX-USA Level 1 score51.7%3.783.7%
Any Failed COMLEX-USA Attempt41.4%4.578.0%
Grades in Clerkship in Preferred Specialty58.6%3.976.8%
Consistency of Grades44.8%4.176.7%
AOA Membership58.6%475.5%
GHHS Membership44.8%3.975.3%
Continuous Medical Education w/o Gaps41.4%3.873.3%
Passing USMLE Step 2 CS48.3%3.773.2%
Awards/Honors, Clerkship in Preferred Specialty37.9%3.672.2%
Awards/Honors in Clinical Clerkships34.5%3.271.8%
Medical School Reputation27.6%3.969.3%
Medical School Accreditation Status31.0%4.669.1%
Passing COMLEX-USA Level 2 PE34.5%3.668.6%
Sigma Sigma Phi Membership24.1%468.3%
Awards/Honors in Basic Sciences20.7%3.365.7%
USMLE Step 3 Score24.1%3.665.6%
COMLEX-USA Level 3 Score24.1%3.663.4%
How Medical School Handled Virtual Rotations13.8%2.862.9%
Interpersonal Skills93.1%4.862.9%
Interactions with Faculty During Interview/Visit89.7%4.962.8%
Feedback from Current Residents82.8%4.561.5%
Interactions with House Staff During Interview/Visit86.2%4.861.5%
Diversity Characteristics58.6%4.461.4%
Perceived Commitment to Specialty86.2%4.661.2%
Letters of Recommendation in Specialty75.9%461.2%
Perceived Interest in Program65.5%4.458.7%
Personal Statement72.4%3.655.5%
Professionalism and Ethics79.3%4.755.0%
Leadership Qualities79.3%4.453.3%
Having Overcome Significant Obstacles62.1%3.852.8%
Personal Prior Knowledge of Applicant65.5%3.952.5%
Other Life Experience55.2%3.852.1%
Volunteer/Extracurricular Experience48.3%3.749.3%
Audition Elective/Rotation in PD's Dept31.0%4.648.6%
Involvement and Interest in Research31.0%3.348.5%
Fluency in Language of Patient Population31.0%448.5%
Ability to Work Legally w/o Visa10.3%4.348.2%
Other Post-Interview Contact31.0%3.348.1%
Interest in Academic Career31.0%3.748.1%
NRMP Flag for Match Violation27.6%4.943.5%
Visa Status6.9%443.4%
Applicant Facility with Meeting Platform Tech17.2%438.2%
Away Rotation in Specialty Elsewhere10.3%3.335.2%
Second Interview/Visit10.3%334.9%

Finally, we can see the composite scores for criteria used to rank neurology applicants.

What Characteristics Do Successful Neurology Applicants Share?

Here are the characteristics of matched vs. unmatched US seniors applying to neurology.

MatchedUnmatched
Mean number of contiguous ranks, US Senior14.55.5
Mean number of distinct specialties ranked, US Senior1.11.5
Step 1, US Senior233217
Step 2, US Senior246229
Mean number of research experiences, US Senior3.93.8
Mean number of abstracts, presentations, and publications, US Senior7.87.6
Mean number of work experiences, US Senior3.24.8
Mean number of volunteer experiences, US Senior7.56
Percentage who are AOA members, US Senior11.40
Percentage who graduated from one of the 40 U.S. medical schools with the highest NIH funding, US Senior30.537.5
Percentage who have Ph.D. degree, US Senior9.40
Percentage who have another graduate degree, US Senior13.937.5
Match Into Neurology: Pass the Screens with High USMLEs

Neurology relies on standardized screens to weed out applicants. In the 2021 Program Director Survey, neurology PDs respondents reported that 48% of applications were rejected via standardized screen. This ranked near the middle of residencies.

What Are the Step 1 and Step 2 CK Cut-Offs for Interviews in Neurology?

As mentioned above, neurology ranks near the middle of programs using standardized screens to eliminate applications. Many neurology programs screen out applicants with failed USMLE Step 1 and Step 2 CK (see below). In addition, PDs use Step 1 and Step 2 CK score cut-offs to weed out applicants.

For Step 1, neurology program directors reported Step 1 score cut-offs between 205 and 220 as 25% and 75%ile marks to screen out applicants.

Similarly, neurology program directors reported Step 2 CK scores between 210 and 220 as 25% and 75%ile cut-offs.

For more on the USMLE cut-off scores for granting interviews – or weeding out applicants – see this article.

If I Fail Step 1, Can I Still Match Into Neurology?

If you failed Step 1, you might wonder if you can still match into neurology. In the most recent program director survey addressing this question, we can see that neurology programs are relatively unforgiving if you’ve failed Step 1.

In 2020, neurology 16% of PDs reported they “never” consider applicants who fail Step 1, while 84% would “seldom” consider it. That said 0% of neurology programs “often” consider someone with a Step 1 fail.

Did you fail Step 1 and are wondering what you can do to recover? Read this article and consider scheduling a consultation.

If I Fail Step 2 CK, Can I Still Match Into Neurology?

Similarly, you may wonder what your chances of matching into neurology are if you fail Step 2 CK. Just like with Step 1, neurology PDs are unforgiving for not passing Step 2 CK.

In 2020, neurology 17% of PDs reported they “never” consider applicants who fail Step 2 CK, while 83% would “seldom” consider it. That said 0% of neurology programs “often” consider someone with a Step 2 CK fail.

Did you fail Step 2 CK and wonder what you can do to recover? Read this article and consider scheduling a consultation.

How Many Publications for Neurology Residency in 2022

Research is an important characteristics for matching into many specialties, particularly the most competitive. So, how many publications do you need to match into a neurology residency?

In 2022, the mean number of abstracts, presentations, and publications for US seniors who matched into neurology was 7.8. The mean number of research experiences was 3.9.

Do I Need an MD-PhD to Become a Neurologist?

You may wonder how much an MD-PhD helps with matching into neurology. It appears that having a PhD correlates with a modest advantage of 2% when applying into neurology. Specifically, the match rate for those with a PhD is 2% higher than for those without one when applying into neurology.

Note that those with PhDs are relatively rare among neurology residents, yet higher than most other specialties. In fact, only 9.4% of matched applicants into neurology had a PhD in 2022.

Neurology Residency Interviews

When you apply to neurology, you may be wondering what the chances of getting an interview are. Here we present the outcomes of applicants per the 2021 NRMP Program Director Survey.

Note that neurology uses standardized screens to reduce the number of applicants. Roughly 48% of applicants that year were eliminated via a screen (e.g., Step 2 CK scores, visa status, failed a USMLE in the past, etc.).

When Are Neurology Residency Interview Invites Sent vs. Conducted?

When you apply to residency, you’ll be doing a lot of waiting. Specifically, you’ll be waiting to hear whether – and when – you will be able to interview.

Want to know when you might expect to hear from neurology programs re: your residency application? Here are when programs typically extend and conduct interviews. Note that the most recent data are from 2020.

Here are the same data presented differently. Note that due to rounding, sometimes the percentages can add up to more than 100%.

How Many Interviews to Match in Neurology?

How many interviews to match in neurology with confidence? For US Seniors, the magic number of interviews needed to match into neurology is 6. In 2022, having 6+ interviews (and ranking them all on their match list) led to a ≥93% chance of matching into neurology for US seniors.

How Many Interviews to Match in Neurology as a DO?

For DO seniors, to get to the 75-80% threshold, ≥ 5 interviews were needed. In 2022, having 8+ interviews (and ranking them all on their match list) led to a 100% chance of matching into neurology for DO seniors.

How Many Interviews to Match in Neurology as an IMG?

More interviews were necessary for IMGs to comfortably match into neurology. To reach the 75% threshold, ≥7-8 interviews were necessary. Note that because of so few candidates with ≥ 10 interviews, the numbers become considerably “noisier,” and can’t be interpreted with much confidence.

Concluding Thoughts

Matching into neurology is a challenging proposition. The challenge may feel more daunting if we have perceived weaknesses in our application, or if we want to match in a top program, a desirable location, and/or couples match.

The good news? How to match into neurology depends largely on things you can control – your USMLEs, your clinical performance/MSPEs, and whether you fail Step 1 or Step 2 CK.

Looking for a Neurology Residency Advisor?

Looking for a neurology residency advisor? Want help writing your personal statement? Need effective strategies for interviewing? Do you have things on your application – e.g., low USMLE scores, failed USMLEs, no research, IMG status, or others – you need help overcoming?

Be sure to check out our Residency Advisor service.

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