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PATHWAYSTONEUROSURGERY TRAININGINTHEUS Neurosurgery Pre-Residency Fellow, RNZ Neurosciences, Lagos, NigeriaOverview ● One of the most competitive specialties ● Requires careful and concrete planning ● Preparation towards a successful match should begin early ● Spans 7 years ● 1-4 residents per year ● Post-grad fellowships afterwardsTheMatchPROCESS ● System by which applicants are placed into a US residency program ● Depends on multiple factors e.g USMLE scores, LORs, Research, medical school ranking, interview performance ● IMGs have lower match rates 1. FREIDA FREIDA Residency Program Database | Medical Fellowship Database | AMA (ama-assn.org) 1. residencyexplorer.org IMGs in the programs 1. NRMP Charting outcomes data and Program survey Match percentage. Number of spotsNRMPData No of PositionNumber MD MD DO DO Others US IMG Non-US program s filled Senior Grad Senior Grad IMG s 115 240 240 202 11 9 0 0 2 16 MD Seniors DO Seniors 275 24 Source: National Resident Matching Program (NRMP) MatchData 2022Source: National Resident Matching Program (NRMP)Program Director SurveySource: National Resident Matching Program (NRMP)Program Director SurveySource: National Resident Matching Program (NRMP)Program Director SurveySource: National Resident Matching Program (NRMP) Program Director SurveySource: National Resident Matching Program (NRMP) Program Director SurveyAcompetitiveportfolio ● USMLE scores ● Grades ● Class Rank ● Research and Publications ● Letters of Recommendation ● Sub-internships/Observerships ● VolunteeringMedicalschoolperformance Grades (MSPE) Class RankingExams Step 1 Step 2 CK Step 3 ECFMG Certification pathways for IMGsChallengesIMGsFace ● Lower match rates ● Visa Status ● Longer post graduation period ● Additional pathways to be competitivePATHWAYSFORIMGS 1. Advanced degrees e.g M.S, PhD 2. Research Fellowship 3. Pre-Residency Fellowship 4. Preliminary Surgery programs (elective rotation in Neurosurgery) 5. Completing residency training in neurosurgery in one’s home country 6. Post-doctoral fellowship under a neurosurgeon-scientist or neurosurgeon in the USUSClinicalExperience ● Sub-internships (home and external) ● Observerships Typically 4-8 weeks Benefits: ● LORs ● Networking ● Mentorship ● Research opportunitiesGet involved. Help and Impress the residents Case report, Data analysis Fast turnaround time on assignments or projects Targeted for intended matchResearch According to the 2018 NRMP Charting Outcomes, the average number of abstracts, presentations and publications, for those matching into neurosurgery was 18.3. Types: Clinical Basic Science research Research Volunteer/ Research Fellowship Where to find opportunities? 1. Institution websites 2. Society websites 3. Connections during electives 4. Emailing specific physiciansQuantity = Productivity AuthorshipLORs 4 Letters 2 Clinical neurosurgeons 1 general surgery clerkship/ subspeciality mentor 1 additional neurosurgery or research mentor ● US letters are important ● From research programs or clinical electives for IMGsVISA JI H1BPOSTGRADYEARS Concern about effects on clinical skills 1. Cadaver Labs or Workshops 2. Join CLinics or Shadow Attendings during research yearsHowtoknowwhentoapply Careful planning Discuss with mentors Polish your CV Reach out to PDs or residents in programs Focus on where you have done research or electives Apply wideINTERVIEW Read about programs and resources available Sell yourself and your unique experiencesRANKING Applicants and P.Ds submit a rank list in order of preference to NRMP which uses a computerized mathematical algorithm to match applicants to programs ● Match all programs you interviewed at ● Discuss with mentors on your rank listAdditional Information ● Neurosurgerymatch.org ● Neurosurgery Research and Education Foundation (NREF) Webinar Series