How I Matched into neurology

When one examines the path to a given specialty—say, how to become a neurologist—it can be helpful to look to those who recently went through the process of matching in that specialty.

A compassionate, whole-person approach to patient care is what first attracted Corinna Fazzio, DO, to neurology in her third year of medical school. She loves problem-solving and dedicating time and mental energy to finding the root cause of her patients’ conditions. A professional background in clinical nutrition and a solid research foundation helped Dr. Fazzio successfully match in the specialty in March 2021.

In this edited Q&A, Dr. Fazzio, now a first-year neurology resident at the University of California-Davis, shares her insights on what medical students can do to prepare for the Match process and what she did to succeed.

What unique training or experiences did you have before medical school?

I majored in clinical nutrition in college and earned a master’s degree in physiology and biophysics. In between my degree work, I was a dietitian in a free clinic and was disappointed to observe a lack of emphasis on nutrition and nutrition education among physicians and residents because I knew what the benefits of proper nutrition in combination with good medical care could be.

I became inspired to pursue medicine and become a physician. My vision was to, as a physician, integrate nutrition into my practice of medicine.

What drew you to the field of neurology?

I was originally interested in internal medicine. I was president of the internal medicine club in medical school, and I thought primary care and general medicine would work really well with my background as a clinical dietician.

Then, during my third year, I was assigned a neurology rotation with an amazing preceptor. From day one on that rotation, I had butterflies in my stomach because I loved it so much.

I realized that there is so much we don’t learn in medical school about the brain and nervous system and that neurology is an expansive and developing field with unique diseases, tests and approaches to the patient. I wanted to know more and be a part of the field.

What is unique about the day-to-day work of a neurologist?

The day-to-day in neurology is really about caring for the patient in a different way. The work of a neurologist is actually very cerebral — pun intended. Each patient gets an extremely thorough history discussion, physical exam and focused work-up. Every detail of a case becomes important in neurology because the nervous system is connected to every body system.

What makes a good neurology applicant?

Like any specialty, board scores are important in neurology. With Level 1 and Step 1 going pass/fail, it’s important to focus on doing well on Level 2, Step 2 and shelf exams. There is a common misconception among medical students that neurology is not highly competitive. On the contrary, there are relatively few neurology residency spots, which makes applying inherently highly competitive.

I would encourage being purpose-driven in your extracurricular activity choices. For example, neurology programs value research and volunteer experiences. It helps to apply with solid letters of recommendation and to practice your interview skills.

In summary, experiences, academic performance, letters and interviews will ultimately help you succeed.

How many away rotations did you do during your fourth year?

Because of the COVID-19 pandemic, I had to stay in-state, even though my programs of interest were out of state. I was still able to do two sub-internships in neurology and two sub-internships in internal medicine.

What did you do to stand out and perform well on away rotations?

I asked a lot of questions and tried to be a “sponge,” so to speak, soaking up everything I was seeing and learning. Also, whenever an attending physician asked me questions, I took the time to learn not only the answers, but why the answers were correct. That way, the next time a different attending asked me a similar question, I could answer it correctly and with confidence. I tried to be curious and overall genuinely myself.

How many programs did you apply to?

22 neurology and 8 preliminary positions.

How many interviews did you complete?

16 interviews.

How many programs did you rank?

Every program at which I interviewed, so, 16.

What factors weighed into your rank order decisions?

Choosing the order of my rank list was one of the most difficult parts of the Match process. There is so much to consider. Some things that were very important to me include the volume and variety of pathologies you might see at one program versus another, proximity to family, the culture of the program and the intensity of the training schedule.

Additionally, the ‘little things’ are more important than you might think. For example, my program provides a stipend for food, free parking and a gym in the hospital, which have made a big impact on my well-being during training.

What was it like applying to your specialty as a DO?

It was intimidating, to be honest. Many of my co-interviewees came from prestigious academic institutions. Sometimes I found myself thinking, ‘Why would they choose me over these students coming from Harvard or Yale, when I come from a small DO program?’

However, at the end of the day, that didn’t matter. What really matters is who you are and what unique qualities you can bring to the program. I did pay attention to which programs had accepted DOs in the past and which didn’t.

That guided my decision-making when it came to ranking my programs. Being prepared to speak about how I plan to use osteopathic manipulative treatment (OMT) in my practice, and how the osteopathic perspective will shape my approach to medicine, was helpful in my interviews.

What personal practices helped you successfully match into neurology?

Volunteering and taking opportunities as they came. Even when it is easier to stay home or not participate, I tried to be involved in lots of volunteer work and chose experiences based on my interests and passions. I stayed curious and involved.

What advice do you have for students who are pursuing neurology?

There are two different pathways in neurology training; learn more about the difference between categorical and advanced programs. I wish I knew this difference earlier, when I was making decisions. Seek out a mentor who can explain this to you, because it’s difficult to understand.

Basically, categorical programs offer the full residency training you need in neurology to qualify for board certification. Advanced programs require to you complete a preliminary training year outside of neurology, often in internal medicine.

In my opinion, applying for advanced programs with the internal medicine year makes it more competitive and adds extra interviews and a whole additional process.

I also encourage students interested in neurology to pursue research in some form and try to publish or present your work.

Do you have additional advice for minority students who are interested in neurology?

I would encourage anyone who is interested in neurology to pursue it. Neurology is a diverse and inclusive field of medicine. You can find your place within our profession. Seek mentors in the field who can guide you as you select programs. Identify programs with visions and missions that match yours.

What should medical students focus on now?

Stay positive and try not to stress about the little things. There will always be another hurdle, so stay present and focus on your well-being. It will take you far.

Related reading:

The world’s 10 best hospitals for 10 different specialties, according to Newsweek

Your questions about matching into residency answered