It has been a pleasure to serve as the chair of the Society of Neurological Surgeons (SNS) Medical Student Committee. This group of neurosurgical leaders is deeply engaged in finding better approaches to training future neurosurgeons. Our responsibilities include enhancing exposure to the field for students exploring future careers, providing a framework of mentorship for those considering a neurosurgical residency, and ensuring that The Match® is fair and efficient for both applicants and programs. It has been clear that forces are making this last goal more challenging for some time.
First, objective evaluation metrics have been eroded in U.S. medical schools. This situation began with grades but has gone on to involve eliminating the United States Medical Licensing Examination® Step 1 scores and many academic honor society chapters. Evaluating an applicant’s clinical knowledge and relative success in medical school coursework on a transcript has become much more difficult. Perhaps in response to these forces, applicants have thrown energy into research activity and increasing numbers of neurosurgery rotations in the hopes of setting themselves apart. While these activities are undoubtedly helpful, there is surely a “ceiling” beyond which more research focus or neurosurgery rotations negatively impact a student’s overall medical education and/or create excess and unnecessary financial burdens.
Finally, we have seen the median number of applications per applicant rise year after year until reaching a point where the median applicant now applies to >80% of all programs. “Application fever” compounds costs and makes holistic review even more difficult for programs to execute efficiently. The SNS Medical Student Committee has carefully reviewed these areas of concern and has produced several new strategies to promote a more efficient match system.
