Ultimate Guide for DO Graduates: Researching Neurosurgery Residency Programs

Choosing a neurosurgery residency is one of the most high‑stakes decisions you’ll make as a DO graduate. It’s not just about “getting in somewhere”—it’s about finding programs where you can realistically match, thrive clinically and academically, and build the foundation for a long career in brain and spine surgery.

This guide walks you step‑by‑step through how to research residency programs as a DO applicant targeting neurosurgery. You’ll learn how to build a focused program list, what to look for on websites and in data, and how to evaluate program culture, DO‑friendliness, and long‑term career fit.

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Understanding the Landscape: DO Graduate in Neurosurgery

Before you start building spreadsheets or emailing coordinators, you need a realistic sense of the neurosurgery residency landscape for DO graduates.

Neurosurgery Is Ultra‑Competitive

Neurosurgery residency is among the most competitive specialties in the Match. Core realities:

• Long, demanding training (typically 7 years)
• Small number of positions per program (often 1–3 per year)
• Heavy emphasis on:
  • Board scores
  • Research productivity
  • Strong letters from neurosurgeons
  • A demonstrated commitment to neurosurgery

As a DO graduate, you are competing in the integrated single accreditation system. Many programs are historically MD‑heavy and may have limited experience training DO residents—but that is evolving.

What Being a DO Applicant Means

For a DO graduate, the osteopathic residency match no longer exists as a separate entity, but the concept of an “osteopathic residency match” still matters strategically: you should identify programs that:

• Have matched DOs in neurosurgery recently
• Have DO faculty or chief residents
• Explicitly welcome DO applicants on their websites or in social media
• Are at or near former AOA‐accredited institutions (legacy DO‑friendly centers)

Your strategy is not to “take any neurosurgery spot,” but to target programs where a DO neurosurgery applicant is both competitive and valued.

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Step 1: Build a Strategic Framework Before You Search

Before you dive into specific institutions, create a program research strategy so you don’t get overwhelmed.

Clarify Your Personal Profile

Start with an honest self‑assessment. This drives how you prioritize and filter programs.

Key components:

1. Board Exams

   • COMLEX Level 1 & 2 scores
   • USMLE Step 1 & 2 (if taken)
     Programs may:
   • Require USMLE scores
   • Accept COMLEX only
   • Strongly prefer/implicitly expect USMLE for neurosurgery

2. Academic Metrics

   • Class rank or quartile
   • AOA membership (for MD schools) or Sigma Sigma Phi / other osteopathic honors
   • Any course or rotation failures/remediations

3. Neurosurgery Exposure & Research

   • Number and quality of neurosurgery‑related research projects
   • Publications, presentations, posters
   • Dedicated neurosurgery research year(s) if applicable
   • Letters from neurosurgeons (especially academic neurosurgeons)

4. Geographic & Personal Constraints

   • Ties to specific regions (family, prior training)
   • Where you absolutely will or will not live for 7 years
   • Visa status (if applicable)

5. Lifestyle & Career Preferences

   • Academic vs community‑academic environment
   • Interest in specific subspecialties (pediatrics, vascular, spine, functional, tumor, trauma)
   • Desire for heavy research vs more clinically focused training

Put this information into a brief document. You will use it to benchmark yourself against the typical neurosurgery resident and tailor your program research strategy accordingly.

Define Your Program Categories

As you research, you’ll want to sort programs into rough categories:

• Reach: Programs where your metrics are below the median, or prestige/research intensity is exceptionally high (e.g., major top‑tier academic centers).
• Target: Programs where your profile is reasonably aligned with recent residents, including DO‑friendly academic centers.
• Safety (Relative): Less research‑intense or smaller programs, or those with a clear track record of training DOs. (In neurosurgery, nothing is truly “safe,” but some programs are more attainable based on history.)

Your goal is not to label programs permanently but to triage where to invest initial research effort.

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Step 2: Create a Structured System for Program Research

The difference between a chaotic search and a targeted one is structure. This is where many applicants fall short.

Build a Master Spreadsheet

Open Excel, Google Sheets, or Notion and create a master neurosurgery residency spreadsheet.

Core columns to include:

Program Basics

• Institution name
• City, state
• Program type (university, community‑academic, military)
• Number of residents per year
• ACGME program ID

DO‑Related

• DO residents currently in program? (Y/N, which years?)
• DO faculty or leadership?
• Statement about DOs on website (supportive, neutral, unclear)
• Former AOA program? (legacy osteopathic site)

Eligibility & Exams

• COMLEX accepted? (Y/N)
• USMLE required or “strongly recommended”?
• Minimum score cutoffs if stated
• Must have taken exams by time of application/interview?

Neurosurgery‑Specific Features

• Major subspecialty strengths (e.g., vascular, peds, spine, functional)
• Level 1 trauma center status
• Pediatric neurosurgery volume (in‑house vs external rotation)
• Call structure (qX, night float, etc., if available)

Research & Academics

• Dedicated research year(s) required or optional?
• NIH funding / active trials? (rough indicator: “high,” “moderate,” “limited”)
• Resident publications (from program website or PubMed search)
• Exposure to grant writing, lab work, outcomes research

Match‑Related

• Historical NRMP data (number of positions, fill rate)
• Any published information on average board scores or research output of matched residents (if available)
• Whether program participates in ERAS/NRMP (most do, but confirm)

Fit & Impressions

• Notes from:
  • Website tone and detail
  • Residents’ social media (Instagram, Twitter/X)
  • Program videos / virtual open houses
• Your preliminary rating (1–5) for:
  • DO‑friendliness
  • Academic fit
  • Geographic fit
  • Overall interest

This spreadsheet becomes your command center for the osteopathic residency match in neurosurgery.

Start with Official Sources

Use the following primary data sources:

1. FREIDA (AMA Residency & Fellowship Database)

   • Filter by specialty: Neurosurgery
   • Export or copy program names and locations
   • Record program size, program type, and contact info

2. ACGME Public Program Listings

   • Confirm accreditation status and resident complement
   • Occasionally see alerts about programs under review or on probation

3. NRMP / Program Director Survey (if available)

   • Review any specialty‑specific PD surveys for how important:
     • Research
     • Letters
     • Board scores
     • DO vs MD status
       is perceived in neurosurgery.

4. Program Websites

   • This is where detailed evaluation begins (see next section).

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Step 3: How to Research Residency Programs Using Public Information

Your program research strategy should begin with in‑depth review of each program’s public footprint before you ever email or call.

Analyze Program Websites Systematically

For each program, spend 20–30 minutes carefully reviewing their website:

1. Resident Roster

   • Look for:
     • Any DOs currently in the program (note their PGY and school)
     • Names you recognize from osteopathic schools or neurosurgery interest groups
   • If DOs are present, this is a strong sign of DO‑friendliness.

2. Faculty Profiles

   • Any faculty with DO degrees?
   • Any who trained at osteopathic institutions?
   • Research interests—do they align with what you might want to pursue?

3. Program Description & Philosophy

   • Do they mention:
     • Diversity of training backgrounds?
     • Openness to DO applicants?
     • Osteopathic manipulation or OMM integration (rare in neurosurgery but sometimes acknowledged for DOs)?

4. Operative and Clinical Experience

   • Look for:
     • Case logs or sample case numbers (cranial, spine, vascular, functional, trauma)
     • Rotations schedule by PGY year
     • Exposure to endovascular, radiosurgery, or complex spine
   • Ask: “Does this look like a brain surgery residency that will prepare me for independent practice?”

5. Research Infrastructure

   • Is there:
     • A mandated research year (often between PGY‑3–4)?
     • A basic science or translational lab?
     • Outcomes research, clinical trials, or device development?
   • Note any formal structure: “Residents average X publications by graduation” or “Dedicated 12–24 months of protected time.”

6. Educational Structure

   • Frequency and type of didactics
   • Morbidity & mortality conferences, tumor boards, journal clubs
   • Board preparation resources

7. DO‑Specific Details

   • Do they state they accept COMLEX alone?
   • Do they explicitly require USMLE?
   • Any language like “We welcome applications from MD and DO graduates”?

Document all of this in your spreadsheet notes.

Use Social Media & Online Presence

For evaluating residency programs, social media is now a major window into program culture.

Check:

• Department/Residency Instagram

  • Resident life, camaraderie, wellness efforts
  • Photos/videos of ORs, conferences, social events
  • Presence of DO residents or mention of osteopathic graduates

• Twitter/X

  • Academic output (conferences, publications)
  • How actively residents and faculty engage with neurosurgery community

• YouTube / Program Videos

  • Virtual tours, PD/resident interviews
  • Tone: welcoming? intense? supportive?

Ask yourself:

• Do residents seem burned out or thriving?
• Is there diversity in background and training (including DO)?
• Does the program highlight resident accomplishments or mostly faculty prestige?

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Step 4: Digging Deeper – Advanced Evaluation Tactics for DO Applicants

Once you’ve done the basic research, you’ll need more nuanced ways of evaluating residency programs specifically as a DO neurosurgery applicant.

Investigate DO‑Friendliness Beyond the Website

Some programs are DO‑friendly but don’t advertise it clearly. To uncover this:

1. Check Resident Biographies Thoroughly

   • Look for:
     • Schools that were historically osteopathic but now integrated
     • DO schools with strong neurosurgery tracks (e.g., PCOM, MSUCOM, etc.)
   • If you see multiple DOs over several years, that’s a very strong sign.

2. Use Alumni Networks & LinkedIn

   • Search LinkedIn for:
     • “Neurosurgery Residency [Program Name] DO”
   • See if DO graduates of that program have gone on to fellowships and academic positions.

3. Connect with DO Neurosurgeons

   • Join:
     • AANS medical student groups
     • DO neurosurgery interest groups or mentorship programs
   • Ask mentors:
     • “Which programs have a solid track record of training DO neurosurgeons?”
     • “Are there programs where a DO applicant is at a meaningful disadvantage?”

Interpret Research Expectations Realistically

Because neurosurgery is heavily academic, research is central to your program research strategy.

Ask of each program:

• Are they research‑intense (top NIH‑funded, many basic science labs)?
• Or clinically focused with moderate research output?

For a DO applicant, particularly if you didn’t do a major research year:

• Programs expecting dozens of publications and a dedicated lab year may be reach programs.
• Programs with strong clinical volumes but moderate research may be better targets, especially if they have DOs in the roster.

Check:

• Resident CVs if posted
• Publication lists for residents on PubMed (search by program name and filter by residents’ names)
• Whether residents frequently present at CNS, AANS, or major subspecialty meetings

Evaluate Training Quality and Case Exposure

A neurosurgery residency should make you a safe, confident brain and spine surgeon by graduation. For each program, consider:

• Case Volume & Complexity

  • Total case numbers approaching or surpassing ACGME minimums
  • Exposure to:
    • Brain tumors (skull base, awake craniotomies)
    • Vascular (aneurysms, AVMs, bypasses)
    • Spine (deformity, minimally invasive)
    • Functional (DBS, epilepsy surgery)
    • Pediatric neurosurgery
    • Trauma neurosurgery at a Level 1 center

• Autonomy & Graduated Responsibility

  • Do senior residents run their own services?
  • Are chiefs leading major cases?

• Subspecialty Coverage

  • If you are already drawn to a subspecialty, does the program have:
    • Dedicated faculty and fellowships in that area?
    • Enough volume for meaningful exposure?

This may not directly relate to being a DO graduate, but you’re training for a lifelong career—clinical strength matters just as much as DO‑friendliness.

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Step 5: Direct Outreach and Networking – Doing It Professionally

Public information will only get you so far. At some point, you must reach out—but strategically and professionally.

Contact the Right People for the Right Questions

Appropriate contacts:

• Residency Program Coordinator

  • Logistical questions:
    • “Do you accept COMLEX alone, or is USMLE required?”
    • “Have DOs matched here in recent years?”
    • “Does your program consider applicants from [your DO school]?”

• Current Residents (Especially DOs)

  • Candid insights on:
    • Program culture and support
    • How DOs are perceived
    • Realistic expectations for research and workload
    • Whether they would choose the program again

How to approach:

• Use a brief, respectful email:
  • Introduce yourself (name, DO school, current year)
  • Explain your interest in neurosurgery and why specifically you’re curious about their program
  • Ask 2–3 focused questions (not a long list)

Example questions for a DO resident:

• “As a DO in your program, have you felt fully integrated and supported?”
• “Do you feel DO graduates have equal opportunities for research and fellowships?”
• “What do you wish you had known as a DO applicant when you were applying?”

Attend Virtual or In‑Person Open Houses

Many neurosurgery programs host:

• Virtual information sessions
• Q&A panels with residents and PDs
• Sub‑internship / visiting student rotation webinars

Use these to:

• Assess tone and inclusivity
• See if DO students or residents are visible and vocal
• Ask politely in group or private chat:
  • “Are DO applicants encouraged to apply?”
  • “How have DO residents performed in your program?”

Document these impressions in your spreadsheet under “Fit & Impressions.”

Use Away Rotations Strategically

For neurosurgery, away rotations (sub‑internships) are often critical.

When choosing aways as a DO:

• Prioritize programs that:
  • Have a history of training DOs
  • Seem open and supportive based on your prior research
  • Are places you’d seriously be willing to match

During the rotation:

• Demonstrate your work ethic, curiosity, and technical potential
• Ask residents quietly about:
  • How DOs are perceived generally
  • Whether any DOs have rotated or matched recently

Your rotation performance can override some paper disadvantages, particularly at a DO‑friendly neurosurgery program.

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Step 6: Refine Your List and Prepare to Apply

After weeks of research, conversations, and open houses, it’s time to refine your list for the osteopathic residency match (through NRMP/ERAS).

Prioritize Programs Using Multiple Axes

Revisit your spreadsheet and score programs (1–5) on:

• DO‑friendliness
• Academic alignment (research intensity vs your profile)
• Geographic preference
• Clinical strength and case volume
• Overall impression / culture

Then categorize:

• High Priority: DO‑friendly, good fit academically and geographically, strong training
• Medium Priority: Reasonable fit but with some concern (e.g., limited DO history, highly research‑intense, or less desirable geography)
• Low Priority: Either major DO barrier, misalignment with your goals, or strong negative impressions

You may still apply to a balanced set across categories, but you’ll know where to focus your interview prep and ranking effort.

Double‑Check Eligibility and Requirements

Before finalizing your application list, verify for each program:

• Do they accept DO graduates (almost all do, but confirm)?
• Are COMLEX scores accepted, or is USMLE mandatory?
• Any special requirements:
  • Research year
  • Minimum number of publications
  • Step 2 score by the time of interview

Don’t waste an application on a program where you’re ineligible by stated policy.

Seek Feedback from Mentors

Share your draft program list and spreadsheet with:

• A neurosurgery faculty mentor (ideally someone who knows the match landscape)
• A DO neurosurgeon if available
• Your school’s advising office

Ask:

• “Are there neurosurgery programs you think I’m overlooking that are DO‑friendly?”
• “Are there programs on my list where a DO applicant with my profile is extremely unlikely to match?”
• “Should I add more clinically focused or smaller programs as targets?”

Revise based on their input, not on prestige alone.

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Frequently Asked Questions (FAQ)

1. Do I need USMLE scores as a DO applicant for neurosurgery residency?

For neurosurgery, USMLE is strongly recommended and often functionally required, even if some programs say they accept COMLEX alone. Many PDs are more familiar with USMLE, and some filters in ERAS or institutional policies may rely on USMLE scores. If you are early enough in your training, taking USMLE (and scoring competitively) greatly broadens your options. If you already did not take USMLE, focus your program research strategy on programs explicitly accepting COMLEX and those with a history of DO residents.

2. How many neurosurgery programs should a DO graduate apply to?

There is no universal number, but most neurosurgery applicants—especially DOs—apply broadly, often to 40–60+ programs, depending on competitiveness. As a DO graduate, you should:

• Apply to all programs that are reasonably DO‑friendly and where you meet basic criteria
• Include a mix of research‑intense academic centers and more clinically focused programs
• Not rely solely on a handful of prestige programs
  Quality of your application matters more than raw count, but neurosurgery is a small field—you want enough breadth to capture realistic opportunities.

3. How can I tell if a neurosurgery program is truly DO‑friendly?

Look for multiple converging signals:

• Current or recent DO residents across several PGY years
• DO faculty or leadership roles
• Clear acceptance of COMLEX and DO graduates on website FAQs or policies
• Positive feedback from DOs who rotated or trained there
• No history of dismissive or negative attitudes toward osteopathic graduates (ask mentors quietly)

Treat “We accept applications from MD and DO students” as a minimum, not a guarantee of equal consideration. Actual resident composition is usually the clearest indicator.

4. Is it realistic for a DO graduate with modest research to match into neurosurgery?

It is possible but more challenging. Many neurosurgery applicants have significant research output, and research helps demonstrate commitment and academic potential. As a DO graduate with limited research:

• Focus on programs with more clinical orientation and moderate research expectations
• Work intensely on 1–2 meaningful neurosurgery projects early in medical school, aiming for at least abstracts or posters
• Consider a dedicated research year if feasible, particularly if you’re aiming for research‑intense programs
• Build strong relationships and letters from neurosurgeons who can personally vouch for your commitment and potential

Your program research and application strategy should reflect your actual profile: target programs where your strengths match their priorities, rather than where prestige alone is highest.

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By approaching this process systematically—understanding the neurosurgery landscape for DO graduates, building a structured spreadsheet, deeply analyzing public data, networking wisely, and refining your list with mentorship—you transform an overwhelming challenge into a deliberate, strategic plan. That’s how you give yourself the best possible chance to match into a neurosurgery residency where you can grow into the brain surgeon you aim to become.