2023-24 Application Process Updates

We are working to update information related to the 2023-24 application process. Please check back soon for updates.

Letters of Recommendation

The SNS has been involved in optimizing the evaluation of medical student applicants. It is important to understand that both applicants and programs value high quality letters of evaluation (LOE). Over the past 2 years, neurological surgery has piloted and collected data on letter of recommendation templates. We continue to optimize the SNS template and educate programs and supervising faculty about its use, in order to develop a fair and balanced evaluation and prevent “grade inflation.” As the application process changes in response to the loss of USMLE I scores, recommendation letters reflecting both home and AI rotation performance will likely have additional influence in the application screening process.

New in 2022: In alignment with the recommendation to undertake 1 Home and 1-2 External AI rotations, the SNS recommends that each applicant obtain the following recommendations:

  • One (1) Home program: SNS Standardized Letter of Evaluation (LOE)
  • One to two (1) External programs: SNS Standardized Letters of Evaluation (LOE)
  • One (1) Individual free-form Letter of Recommendation (LOR)

At each program, LOEs should be written by an evaluation committee, which will commonly involve the department chair, PD, and core education faculty who have worked with each AI. LOEs should provide a fair and balanced evaluation of each applicant. The free-form letter (LOR) may come from any individual mentor at the home or external rotation programs who knows the applicant well: clinical, research, or other.

If you have done any research, one of the letters could be from your research advisor. There is no doubt it is of great help if the people writing your letters are well-known, but a lukewarm letter from a chair does not stand up to a strong letter from a lesser known neurosurgeon. In general, letters from non-neurosurgeons (general surgeons, pediatricians, OB-GYNs, etc.), even if they are very strong, are of little benefit as these specialists are not generally able to understand the unique rigors of neurosurgical residency. It is advisable to do one to two away rotations early in the application process (summer), and get letters from these institutions. A strong chair letter from an away rotation is a considerable addition to your application. You should strive for a letter from every program at which you did a sub-internship. Though they may not all be available at the time the application process opens, you must have at least three letters to be highly considered.