How competitive is neurology residency?

The nervous system is the most complex in the universe, every day there are more advances in neuroscience. But, precisely because it is so difficult to understand and because it does not have a cure for many diseases, it makes neurology not a specialty that residents prefer … or is it?

In this brief guide we are going to answer the question ‘’How competitive is neurology residency?’’ We will analyze the competitiveness indices in neurology residency programs, we will detail what a star applicant needs and we will explain why certain students do not choose neurology as a specialty.

How competitive is neurology residency

Neurology residency is not as competitive as other specialties. We could say that it is a middle point.

Neurological diseases are the second leading cause of disability in the world.

Among them are very prevalent diseases such as dementia and stroke, and others less frequent but as devastating as amyotrophic lateral sclerosis or Huntington’s disease. Given the complexity of our brain, the only way to advance in the treatment of these diseases is through research.

During the last decade, we have witnessed an important modification of neurology in clinical practice due to the explosion of new information and new technologies in the field of neuroscience.

The training of students and training specialists, as well as postgraduate education, are oriented towards these new technologies, leaving traditional clinical medicine in the background.

Neurology residency competitiveness

For the top programs, it is fairly competitive, but there are enough good programs that should compete well with most good students. Average and lower programs appear to fill up with international medical graduates, so the competition is possibly below average overall.

In 2020, there were a total of 1,068 candidates and 946 spots in neurology. This is equal to 1.13 candidates per position. Among the 458 U.S. 13 were not matched by MD seniors who applied.

What about the DO’s?

The average number of DO Senior Applicants was 127 in 2020. 118 of those, for a 92.91 percent match rate, matched. For osteopathic students, this makes neurology a very pleasant area.

And… the honors, publications, etc?

There were 7.6 voluntary experiences and 3.1 job experiences for the average matched U.S. applicant. They had 3.6 interactions and 7.2 abstracts, presentations and publications in science. That makes this speciality where Medium is the number of publications needed.

What do You need to Match into a Neurology Residency Program?

A survey was conducted by the National Resident Match Program to determine the factors that program directors consider when determining which applicants to interview and rate for their residency program.

The findings were compiled into a “one-look” tool that is extremely helpful in measuring where your application package stands relative to the applicant pool, and if adding additional elements, such as a speciality letter of recommendation (LOR), could give you a leg up as your application is evaluated by programs.

Most important components of the survey you should pay attention

A significant consideration is getting an acceptable Phase 1 or COMLEX score in neurology, but the good news is that your targets for these do not have to be in the egregiously high range required by specialities such as dermatology and neurosurgery!

As we will clarify below, in most cases having a Stage score of > 220 is just perfect, and even below that is not an issue as long as you apply more generally.

Step 1 Scores

In neurology, 240 + is a very solid ranking, with the median being 230.

Usually, range services do not have interviews: 210 seems to be the minimum requirement that we can suggest for enough interviews to have a reasonable chance. If you’re below this range, we recommend that you could consider getting a back-up specialty.

Range programs usually give interviews: 230 + tends to be the range at which a decent number of programs would feel comfortable providing interviews. You should probably be careful about where you apply if you’re in the 240 + category.

Step 2CK – Timing of Taking the Exam

Almost 50% of the programs require the complete test, while only 25% require at least to have passed the CK. This means that you must pay close attention to your CK, we would even recommend that you do it before sending the ERAS.

What if I fail in Step 1?

In ANY specialty, failing Phase 1 is a bad signal, but thankfully this is not as important in neurology as in other specialties such as neurosurgery or dermatology.

If you’ve failed Step 1, almost 30 percent of neurology services won’t accept you and almost 40 percent will NOT consider you if you’ve failed Step 2 CK. So, you can still apply if you’ve missed an exam, but you can apply for a large number of programs.

What you should know about neurology residence programs

In most cases, foreign graduates (U.S. and non-U.S.) may not face major obstacles to neurology

Approximately 55% of US programs frequently interview U.S. IMGs, while 45% often interview non-U.S. IMGs. Just a meagre 8% and 5% say that US and non-US IMGs have never been interviewed. Although this factor will, in a few cases, reduce the competitiveness of your application, it is not prohibitive for this sector.

Get Rated interviewees!

If you get an invitation to an interview, you are very likely to end up on the rank list. Depending on how competitive you are, we suggest ranking between 10 programs, so once you get this many interviews invites, you should feel okay with starting to prioritize and cancel when more come in because you are likely to get ranked.

Expect to receive most invitations for interviews by October

Approximately half of the invitations for interviews will be sent out during October, with 30 percent in September.

If you haven’t heard from the residency programs you applied for by the end of October, don’t worry, there’s still a chance, but this is generally the most common period.

Expect an interview in November/December

Beginning in November, approximately 70 percent of interviews take place, which gives you enough time to prepare for your interviews.

What is what makes a competitive neurology applicant?

Neurology, for those who want to deal in problem-solving and a pragmatic approach to the mysteries of the human brain, is a smaller yet increasing discipline. In general, neurology services concentrate on the entire nominee for residency, making it less competitive than other specialties.

But, you’ll need:

  • Having stronger grades
  • Having excellent board scores makes you more competitive.
  • Geography relies on: As a whole, neurology is not as competitive as radiology or orthopaedic surgery.
  • Strong experience with shadowing
  • Find a way to take part in an elective neurology

Why people don’t choose neurology?

One of the most critical career choices you can make is selecting a specialty, and many students compile a list of advantages and drawbacks for each specialty they are considering to make that decision a little simpler. However, if you are considering neurology, that’s not really required.

Low earnings

Neurologists were ranked 16th out of 22 specialties in terms of sales, according to a new Medscape survey. There are at least 15 better specialty options if making money is one of your goals.

No glory

You are in a meeting with your old friends, they ask you: ”What do you do?’’ And say ”I’m a Neurologist ”, many remain like … ” Oh, are you a neurosurgeon? Incredible!”

If you explain that a neurologist does not work on the brain, you will get a blank look and the question, “Then what are you doing?” If even a modicum of glory is needed by your ego, pick a specialization in surgery.

Too much information

Combined with an growing array of therapeutic options for neurological disorders, the central and peripheral nervous system, its anatomy, physiology, and pathology, provide an entirely new universe of knowledge. That’s why neurology is the only medical subspecialty that, after internship, requires its own residency training program.


The most thorough and time-consuming of any medical examination is the neurological exam.

55 percent of neurologists spend 25 minutes or more on each patient, compared to just 15 percent of other doctors, according to the Medscape study. Sling your stethoscope around your neck and find another speciality if you are not happy wearing a black bag and don’t like using your ophthalmoscope and reflex hammer.

Few procedures

There is not much action, at best, the only procedure is the lumbar puncture that is performed to rule out infections in the central nervous system, and is key to providing information on diseases such as Azheimer and multiple sclerosis.

Also, you may perform electromyography and nerve conduction tests throughout your physical exam if the diagnosis requires it.

But beyond that, there isn’t much action.

So, how competitive is neurology residency?

It’s one of those people who love or hate stuff like that. The most convincing reason to choose it, sort of like psychiatry or pediatric, is that you really love it.

Even if you’re like me and you don’t hate neuro, unless you really love it, you will never want to do it as a profession. It appears to be less competitive because there aren’t as many of these individuals.

Also, the fact that it is not as competitive as other specialties makes it appear that it is not competitive.

In terms of hours (night call) and intellectual demand, the bottom line is that it is a difficult residency and most probably the toughest non-surgical residency. But the lifestyle can be vastly better as a participant. Neurology residencies are heavily inpatient, but most sub-specialties of neurology are outpatient-based.

If you think you’re going to be happy doing neuro for the next 40 years of your life, then go for it. Forget anything about competitive or not competitive and boring or interesting.

FAQS: How competitive is neurology residency?

How hard is neurology residency?

Residency in neurology is difficult. As a medical student, it’s tougher than anyone would imagine. That is considerably more complicated than a medical residency, I would agree, and even more taxing than a residency in psychiatry. Neurological learning is close to radiological learning.

Is neurology hard to match?

Not at all. In 2018, only 3.5% of the residents who applied were not selected.

Is Neurology a competitive specialty?

No, it is not competitive, or at least not that much.

What Step 1 score do you need for neurology?

You need a minimum of 230 in Step 1 to be considered in the program.

Is Neurology a hard specialty?

Neurology, it seems, has a reputation as being particularly challenging among medical specialties.


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Neurology | The Successful Match. (2018). Retrieved November 4, 2020, from The Successful Match website: