Pre-residency neurosurgical fellowship programs impact on a successful re-application: a departmental experience

Matching into neurosurgery residency within the United States is one of the most competitive endeavors for medical students. Pursuing a neurosurgery pre-residency fellowship program is becoming a popular option among domestic applicants, as well as international medical graduates (IMGs), who are unsuccessful in their neurosurgery match or wish to create a more competitive application prior to applying. The aim of this study was to review the University of Miami's pre-residency fellowship program experience to date. Records were retrospectively reviewed for all pre-residency fellows that rotated within the Department of Neurosurgery at the University of Miami between 2000 (inception) to 2024 with match success rate as the primary outcome of interest. A total of 23 pre-residency fellows who trained within the University of Miami's Department of Neurosurgery since the inception of the program were identified during the study period of 2000 to 2024. There were 15 (65%) IMGs and 8 (35%) United States medical graduates based on previous medical education. All of the fellows successfully completed their pre-residency training, and 12 (53%) successfully matched into neurosurgery. Another significant trend noted was that IMGs had more research and post-graduate neurosurgical experiences compared to US medical graduates at the time their fellowship began. Pre-residency fellowship programs are a feasible and tangible alternative route for neurosurgery match applicants who wish to augment their application. The outcomes of our pre-residency fellowship are promising, particularly for IMGs, however more prospective data and experiences across multiple departments are required to truly understand parameters of success for pre-residency fellowship programs in neurosurgery.