Competitiveness: Extreme

Neurological Surgery (or Neurosurgery) is not a career path to be taken lightly by any prospective medical professional. Residency training can take up to 7 years of intensive surgical training. Neurological Surgery is among the most competitive specialties and will require a lot of extra work and forethought to prepare a competitive application. Three main ways to improve your application for Neurosurgery are to get a very high USMLE Step 1 exam score (+240), complete a sub-Internship or away rotation in Neurosurgery, and have lots of related research. Since Neurosurgery is such a small specialty, Letters of Recommendation from Neurosurgeons can go a long way.

ENTER YOUR CREDENTIALS Customize your Neurosurgery program list

IMG Profile

Average Stats for a Matched US IMG in 2020:

  • USMLE Step 1 score: 239
  • USMLE Step 2 CK score: 250
  • Research: 2.0
  • Abstracts/Presentations/etc: 28.2
  • Work: 4.3
  • Volunteer: 2.0

Average Stats for a Matched Non-US IMG in 2020:

  • USMLE Step 1 score: 243
  • USMLE Step 2 CK score: 244
  • Research: 3.7
  • Abstracts/Presentations/etc: 60.8
  • Work: 4.7
  • Volunteer: 2.3

Specialty Factors

Every specialty has unique factors they want each candidate to have in their residency application. NRMP conducts regular Program Director surveys to identify which parts of the residency application are most important in differing specialties. Among the information gathered, Program Directors were asked to cite factors they used to select candidates for interviews. They were also asked to rate each factor on a scale from 1 (least important) to 5 (most important).

The Top 5 Most Important Neurosurgery Application Factors

Percentage of Programs Citing Each Factor

  1. Specialty specific Letters of Recommendation (92%)
  2. USMLE Step 1 score (92%)
  3. Personal prior knowledge of the applicant (69%)
  4. Perceived commitment to specialty (69%)
  5. Audition elective/rotation within your department (69%)

Average Importance Rating for Each Factor (scale of 1 to 5)

  1. Any failed attempt in USMLE (5.0)
  2. Applicant was flagged with Match violation by the NRMP (5.0)
  3. Fluency in language spoken by your patient population (5.0)
  4. Perceived commitment to specialty (4.9)
  5. Letters of recommendation in the specialty (4.8)

Fast Facts

Total Training 7 years neurosurgical residency
4.5 years must be core clinical surgery 12 months as chief resident; » 3 months of basic neuroscience; » 3 months of critical care relevant to neurosurgery patients, and » 6 months of structured education in general patient care
2.5 years of electives
Average Residency Salary $69,500
Average Physician Salary $634,500
Average Work Week 58.2 Hours
Peak Interview Months November
Key Organizations and Societies: American Board of Neurological Surgery
American Association of Neurological Surgeons
American Board of Pediatric Neurosurgical Surgery
Congress of Neurological Surgeons
Society of Neurological Surgeons
Women in Neurosurgery
World Federation of Neurosurgical Societies
American Association of Neurological Surgeons: Trainees
  • Neurosurgery is a competitive specialty, especially for IMGs.
  • It is one of the top-paid specialties in medicine.

Match Statistics

Main Residency Match and Post-Match Stats


IMGs Matched

112 /

Number of Programs/Positions


Post-Match SOAP Unfilled Positions

Main Residency Match


Post-Match SOAP

Program Track PGY-1
Participating Programs 0
Filled Programs 0
Positions Available 0
Filled Positions 0


  • Cerebrovascular & Skull Base Surgery
  • Endovascular Surgical Neuroradiology
  • Functional Neurosurgery
  • Neuro-Intensive Care
  • Neuro-Oncology
  • Neurotrauma
  • Pediatric Neurosurgery
  • Spine Service