Neurology Residency Application in the United States
- Ash Eighaei Sedeh MD
- Apr 8
- 14 min read
Welcome US Neurology Residency Applicants!
We hope you find this guide helpful.
Our team at IMG Rotations is happy to be a part of your journey.
Table of contents:
"If you would like our help in your residency match journey, schedule a free call with one of our US-based physician-advisors HERE. Alternatively, check out our all-inclusive comprehensive advisory package HERE."
Neurology residency in the U.S. is a specialized postgraduate program focused on diagnosing and treating disorders of the nervous system, including the brain, spinal cord, peripheral nerves, and muscles. The training provides a balanced mix of inpatient and outpatient neurology, offering exposure to a wide range of neurologic conditions such as stroke, epilepsy, multiple sclerosis, movement disorders, neuromuscular diseases, and neurodegenerative disorders.
Neurology is a moderately competitive specialty, and International Medical Graduates (IMGs) have a strong track record of success in matching, particularly when they have U.S. clinical experience, solid USMLE scores, and well-crafted applications.
Structure of Neurology Residency in the U.S.
Neurology residency typically lasts four years:
Preliminary (Intern) Year: usually in Internal Medicine
3 Years of Neurology Training (PGY-2 to PGY-4)
Some programs are categorical, meaning they include the intern year; others are advanced, and applicants must apply separately to a preliminary year program (commonly in Internal Medicine).
Training Breakdown
PGY-1 (Preliminary Year):
Focus on general Internal Medicine. Rotations include inpatient wards, emergency medicine, ICU, and outpatient clinics, helping build clinical foundations and documentation skills.
PGY-2 (Neurology Year 1):
Introduction to core Neurology services such as stroke, epilepsy, general neurology, and inpatient consults. Exposure to outpatient neurology and emergency neurological care.
PGY-3:
Advanced subspecialty rotations like neurocritical care, EMG, EEG, movement disorders, neuroimmunology, neuromuscular medicine, and more. Greater autonomy in consults and patient management, with opportunities to mentor junior residents and participate in research.
PGY-4 (Chief/Leadership Year):
Senior responsibilities including supervising junior residents and consult teams. Opportunity to tailor electives in areas like interventional neurology, headache medicine, academic neurology, or research. Prepares residents for board exams and independent practice or fellowship applications.
Exams Required During Neurology Residency
Annual In-Training Exam (RITE):
This exam assesses knowledge across all neurology subspecialties and helps guide board preparation.
Board Certification:
After completing residency, graduates must take the American Board of Psychiatry and Neurology (ABPN) exam.
Application Process for Neurology Residency
Applicants apply through ERAS (Electronic Residency Application Service) and participate in the NRMP Match. A complete application includes:
USMLE Step 1 & Step 2 CK scores
Medical school transcripts
Letters of Recommendation (LoRs) – ideally from U.S.-based Neurology attendings
Personal Statement expressing interest in Neurology
MSPE (Dean’s Letter)
ECFMG Certification (for IMGs)
USMLE & Step 3 Tips for Neurology Applicants
Step 1 and Step 2 CK: Aim for scores above 230 for competitive programs. Some programs may screen based on Step 1 alone.
Step 3: Not required for applying but may strengthen IMG applications, especially for those seeking H-1B visa sponsorship.
U.S. Clinical Experience (USCE) for Neurology
Strong U.S. Clinical Experience is highly preferred for IMGs, especially hands-on electives or sub-internships in Neurology. Seek out observerships, externships, or clinical rotations at U.S. academic hospitals with Neurology departments to show familiarity with the U.S. healthcare system, EMR use, and clinical reasoning.
Letters of Recommendation
At least 2-3 strong LoRs from U.S. Neurology physicians are ideal. A letter from the Department Chair of Neurology can carry additional weight. Focus on highlighting your analytical thinking, clinical performance, and interpersonal skills.
IMG-Friendly States for Neurology Residency
Although Neurology is more competitive than specialties such as Family Medicine, many programs across the U.S. are welcoming to IMGs. States known for being more IMG-friendly include:
New York:
Large number of programs, diversity, academic/community blend, and visa sponsorship common.
Michigan:
Affordable, IMG-welcoming, many programs sponsor J-1 and H-1B visas.
Florida:
Several academic programs accept IMGs; strong patient diversity and year-round training.
Texas:
Highly sought-after; competitive but with multiple IMG-accepting programs.
Illinois:
Chicago and surrounding areas have IMG-friendly academic and community programs.
New Jersey:
Community-based programs with a strong IMG history.
Pennsylvania:
Mix of academic and community-based programs with diverse patient populations.
IMG-Friendly Neurology Residency Programs (Examples)
SUNY Downstate Medical Center, Brooklyn, NY
University of Miami / Jackson Health System, Miami, FL
Wayne State University / Detroit Medical Center, Detroit, MI
Rutgers NJMS, Newark, NJ
Temple University, Philadelphia, PA
University of Illinois at Chicago, Chicago, IL
Texas Tech University, Lubbock, TX
Stony Brook University Hospital, NY
LSU Health Sciences Center, Shreveport, LA
These programs often have a consistent record of accepting international graduates and sponsoring visas (mainly J-1, sometimes H-1B).
Key Strategies for IMGs Applying to Neurology
Maximize Your USMLE Scores:
A score over 230 on Step 1 and Step 2 CK improves your chances. Consider taking Step 3 early if seeking H-1B sponsorship.
Secure Robust U.S. Clinical Experience:
Aim for Neurology-focused clinical exposure, especially at academic institutions. Subinternships or electives are preferred over observerships.
Craft a Neurology-Focused Personal Statement:
Emphasize your interest in clinical reasoning, brain-behavior relationships, or specific subspecialties (e.g., epilepsy, stroke). Share your journey and why neurology aligns with your strengths and values.
Apply Broadly & Smartly:
Consider applying to 80–120 programs depending on competitiveness. Include a mix of academic and community-based residencies. Apply early, ideally on ERAS opening day.
Highlight Research & Academic Interests:
Programs value candidates with scholarly potential. Showcase any publications, posters, or neurology-related research, especially U.S.-based.
Show Long-Term Commitment:
Mention your interest in fellowships, teaching, or underserved neurology care. Discuss how you plan to contribute to the U.S. healthcare system.
Prepare for Interviews Thoroughly:
Practice discussing neurologic case experiences, clinical acumen, and adaptability. Be ready to explain your IMG journey with confidence and humility.
Neurology Career & Salary Outlook
Neurologists in the U.S. are well-compensated, particularly with subspecialty training. Average annual salaries vary by practice setting:
Academic Neurology
$190,000–$230,000
General Outpatient Neurology
$240,000–$280,000
Subspecialty Practice (e.g., Epilepsy, Stroke, Neuroimmunology)
$280,000–$350,000+
Neurohospitalist
$300,000–$400,000
Private Practice / Partnership
$350,000–$450,000+
Tele-Neurology / Locum Tenens
Varies ($150–$250/hr)
Sample Personal Statement for Neurology Residency Application
A personal statement is a critical part of your neurology residency application. It offers a space to convey your unique background, passion for the field, and the qualities that make you an ideal candidate for a neurology program. A well-crafted statement should reflect a deep understanding of the specialty, personal motivation, and readiness for rigorous training.
Sample Personal Statement:
"My interest in neurology began during my early medical school years, sparked by a lecture on neuroanatomy that introduced the complexity and elegance of the nervous system. What began as intellectual fascination quickly evolved into a clinical calling as I encountered patients whose lives were deeply affected by neurological disorders. One patient in particular, a young woman with newly diagnosed multiple sclerosis, left a lasting impression. The diagnostic process, the uncertainty of disease progression, and the careful coordination of care among multiple specialists illustrated the challenges and the meaningful impact a neurologist can make. That experience solidified my commitment to pursue neurology.
Throughout medical school in [Your Country], I gravitated toward rotations that allowed me to explore the nervous system in both acute and chronic care settings. I found the diagnostic process in neurology deeply engaging, combining detailed clinical reasoning with advanced imaging and electrophysiology. Whether evaluating a stroke patient in the emergency department or following up on epilepsy management in outpatient care, I was drawn to the breadth and depth of the specialty.
To enhance my understanding of neurology in the U.S. context, I completed a clinical observership at [Institution], where I worked closely with neurologists across subspecialties. I learned not only the clinical protocols but also the value of interdisciplinary collaboration, patient education, and longitudinal care. I was particularly inspired by the empathy and precision with which neurologists approached complex diagnoses, and how they helped patients navigate life-changing conditions with dignity.
In addition to clinical exposure, I have participated in research on cognitive decline in aging populations, which helped me develop analytical thinking and an appreciation for evidence-based practice. I also volunteered with a community outreach program focused on stroke prevention in underserved communities. These experiences shaped my awareness of health disparities and my commitment to equitable neurological care.
As an international medical graduate, I bring a diverse perspective and a strong work ethic shaped by resource-limited environments. I am looking for a residency program that values mentorship, academic curiosity, and patient-centered care. My goal is to become a well-rounded neurologist with interests in neuroimmunology and academic medicine, contributing to both clinical excellence and the education of future physicians.
I am eager to join a program where I can continue developing the skills, knowledge, and empathy required to provide outstanding neurological care. I view residency not just as a period of training, but as a foundation for lifelong service in a field that continually challenges and inspires me."
Key Elements of a Strong Neurology Personal Statement
Engaging Introduction
Begin with a meaningful patient encounter or academic moment that introduced you to neurology.
Clear Motivation
Explain what draws you to neurology: problem-solving, disease complexity, longitudinal care, etc.
Clinical and Research Experience
Highlight exposure to neurological cases, observerships, or research relevant to neuroscience or neurodegenerative diseases.
Personal Qualities
Emphasize analytical thinking, empathy, communication, teamwork, and adaptability.
Future Goals
Include interests in subspecialties like stroke, epilepsy, movement disorders, or academic/research-oriented practice.
Confident Conclusion
End with a statement of commitment and enthusiasm for joining a neurology residency program.
"If you like our help with research, check our complete list of active and upcoming research projects HERE and to see our available hands-on US clinical experiences, check HERE!"
Sample Letter of Recommendation for Neurology Residency
To the Residency Selection Committee,
I am pleased to write this letter in strong support of Dr. [Name]’s application to your neurology residency program. I had the opportunity to supervise Dr. [Name] during a clinical observership at [Institution], where they worked with our neurology team in both inpatient and outpatient settings.
From the beginning, Dr. [Name] demonstrated a keen interest in the diagnostic process and an exceptional ability to connect with patients facing neurological illness. Their attention to detail, willingness to ask insightful questions, and thoughtful approach to clinical reasoning were impressive. One example that stands out is their interaction with a patient presenting with early signs of Parkinson’s disease. Dr. [Name] carefully reviewed the case, formulated a differential diagnosis, and respectfully engaged with the care team during clinical discussions.
Beyond clinical skills, Dr. [Name] showed professionalism, cultural sensitivity, and maturity well beyond their level of training. They participated in daily rounds, neuroimaging review sessions, and case presentations with consistent enthusiasm and preparation. Their genuine empathy and active listening were evident in every patient encounter.
Dr. [Name] also contributed meaningfully to our weekly teaching conferences, raising thoughtful questions and reflecting a deep curiosity about neurophysiology and disease mechanisms. I am confident that they will thrive in the intellectually rigorous and emotionally demanding field of neurology.
I recommend Dr. [Name] without reservation to your program. They are a promising future neurologist who will be an asset to any residency team.
Sincerely,
How to Prepare a Strong CV for Neurology Residency
Your CV should highlight academic strengths, clinical neurology exposure, research achievements, and any service or leadership roles that align with the specialty.
Contact Information
Full name, address, phone number, professional email
Education
Medical school name, location, datesHonors, distinctions, or scholarships
Clinical Experience
Neurology electives, sub-internships, observershipsSettings: academic hospitals, community clinics, tertiary careKey experiences: stroke, epilepsy, neuro ICU, movement disorders
Research Experience
Neurology or neuroscience-related researchProjects on neurodegenerative diseases, cognition, neuroimaging, etc.List your role, outcomes, publications or presentations
Volunteer Experience
Health education, stroke prevention, patient support groupsDemonstrates community involvement and service orientation
Leadership and Activities
Academic societies, journal clubs, mentorship rolesExamples that reflect initiative and collaboration
Publications and Presentations
Case reports, posters, or peer-reviewed articles related to neurology or general medicine
Certifications
USMLE Step 1 and Step 2 CK scoresStep 3 (if available)BLS/ACLS, ECFMG certification for international graduates
Skills
Proficiency with EMR systems, EEG/EMG familiarity (if applicable)Multilingual communication, counseling, public speaking
References
Available upon request or listed if required by the program
What Is the Average USMLE Step 2 CK Score for Neurology Residency Match in the US?
The United States Medical Licensing Examination (USMLE) Step 2 Clinical Knowledge (CK) is a critical component of the residency application process. With Step 1 now being reported as pass/fail, Step 2 CK has taken on even greater significance. For those applying to neurology, understanding typical score ranges and program expectations is key to building a competitive application strategy.
Importance of USMLE Step 2 CK in Neurology
Neurology is a moderately competitive specialty with a growing demand for skilled clinicians and clinician-scientists. Program directors use Step 2 CK to evaluate a candidate’s clinical reasoning, foundational knowledge in neuroscience, and overall readiness for residency training. A solid Step 2 CK score can help strengthen your application, particularly for international medical graduates (IMGs) or those without a strong research background.
According to NRMP and ERAS data, Step 2 CK scores are one of the top metrics used by neurology programs for both interview selection and applicant ranking.
Average USMLE Step 2 CK Score for Matched Applicants
Recent match statistics indicate that successful neurology applicants generally have Step 2 CK scores in the range of 235 to 250.
A score of 245 to 255 is considered competitive for most university-based neurology programs.
IMGs are advised to aim for a Step 2 CK score of 245 or higher to remain competitive, especially when applying to academic or university-affiliated programs.
Some community-based or IMG-friendly programs may accept applicants with lower Step 2 CK scores, particularly when supported by strong U.S. clinical experience (USCE), compelling letters of recommendation, and a focused personal statement.
How Step 2 CK Score Affects Match Chances in Neurology
Above 255:
Highly competitive for academic neurology programs with research components or subspecialty tracks.
245–255:
Strong and competitive range; offers flexibility when applying to both academic and community programs.
235–245:
Still competitive, especially if supported by strong clinical evaluations, U.S. experience, and strong LORs.
225–235:
May be considered at some programs, especially those that are community-based or emphasize holistic review.
Below 225:
Considered low for neurology. Applicants should compensate with significant U.S. clinical exposure, solid Step 3 scores (if available), and a strong narrative throughout the application.
Complementary Factors for a Strong Neurology Application
A strong Step 2 CK score is important, but neurology programs also look for well-rounded candidates who demonstrate intellectual curiosity, clinical maturity, and a deep interest in neurosciences.
These attributes can be reflected through:
Clinical Experience
Neurology rotations, both inpatient and outpatient, are vital. Performance in core clerkships and electives in stroke units, epilepsy monitoring, or neuro-ICU can signal your capability and interest.
Letters of Recommendation
Letters from neurologists, especially U.S.-based faculty, are highly valued. Effective LORs comment on your critical thinking, professionalism, patient interaction, and clinical knowledge specific to neurology.
U.S. Clinical Experience (USCE)
For IMGs, hands-on U.S. neurology rotations demonstrate your familiarity with the American healthcare system and your ability to communicate and collaborate effectively in a multidisciplinary setting.
Personal Statement
Your statement should clearly convey your passion for neurology and explain what draws you to the specialty. Highlight formative experiences—whether clinical, academic, or personal, that shaped your decision. Emphasize intellectual engagement, patient-centered care, and long-term goals.
Research
Although not mandatory, research experience, especially in neuro-related fields (stroke, epilepsy, neuroimmunology, neurodegeneration), can strengthen your application. Publications and abstracts are advantageous for university programs.
Communication and Interpersonal Skills
Neurology requires clear communication with patients, many of whom have complex or chronic conditions. Programs look for applicants who are articulate, empathetic, and demonstrate excellent bedside manner, both in written applications and interviews.
Year of Graduation and Academic Gaps
Recent graduates are generally preferred. However, applicants with older graduation dates can remain competitive if they show continued clinical activity, updated certifications, and a demonstrated commitment to neurology.
Do I Need Step 3 to Match Into Neurology Residency?
Step 3 is not required to apply for neurology residency. However, under certain circumstances, especially for IMGs or those seeking H-1B visa sponsorship, completing Step 3 can enhance your application.
When Step 3 May Help
If you are an IMG with an older graduation year.
If your Step 1 or Step 2 CK score is below average.
If you are applying to H-1B–sponsoring programs (many require Step 3 for visa processing).
Step 3 Can Be Beneficial By:
Demonstrating clinical competence and progression.
Enhancing eligibility for H-1B visa sponsorship.
Indicating a serious commitment to practicing medicine in the U.S.
Potential Drawbacks
Preparing for Step 3 is time-intensive and costly.
A failing score can negatively affect your application.
For most U.S. graduates, it offers minimal added value before residency.
Check our blog post on USMLE Step 3 HERE!
Visa Considerations for IMGs Applying to Neurology
Both J-1 and H-1B visas are viable pathways, but each has distinct implications for future career planning.
J-1 Visa
Sponsored by ECFMG.
Does not require Step 3.
Requires a return to the home country for two years unless waived.
Often the default for most academic and community programs.
H-1B Visa
Sponsored by the residency program.
Requires a valid Step 3 score before employment begins.
Allows transition to permanent residency or fellowship in the U.S.
Preferred by IMGs aiming to remain in the U.S. long term.
While many neurology programs are J-1 friendly, a growing number of university-affiliated and urban programs are open to H-1B sponsorship, especially if the applicant has passed Step 3 and meets all other eligibility criteria.
Key Factors Neurology Residency Programs Consider for Interview Selection
Neurology program directors evaluate candidates holistically. Your application should reflect academic strength, intellectual interest in neurology, strong clinical skills, and the ability to thrive in a collaborative environment.
USMLE Scores:
Especially Step 2 CK, which demonstrates clinical readiness and applied knowledge relevant to neurology.
Clinical Experience in Neurology:
Rotations that reflect exposure to neurologic patient populations and continuity of interest in the field.
Letters of Recommendation:
From neurologists who can attest to your strengths in clinical reasoning, communication, and teamwork.
Personal Statement: A thoughtful, introspective narrative explaining why neurology is your chosen path.
Research and Academic Curiosity:
Experience in neuroscience, neuroimaging, or neurophysiology research is a plus for academic programs.
Communication and Empathy:
Essential in managing complex and often chronic neurologic conditions.
Graduation Year: More recent graduates are often favored, but older graduates with sustained clinical engagement and strong scores remain viable.
Visa Status (for IMGs):
Be transparent about your visa needs. Step 3 completion increases your options, especially for H-1B sponsorship.
Top Factors Neurology Program Directors Consider When Ranking Candidates for the Match
Securing an interview is an important milestone, but how you present yourself during and after the interview plays a key role in where you are placed on a program's rank list. Neurology programs look for applicants who demonstrate intellectual curiosity, strong clinical reasoning, and a deep commitment to the field.
Interview Performance
The interview often carries the most weight in ranking decisions. Program directors assess your communication skills, professionalism, maturity, and enthusiasm for neurology. Be prepared to discuss your interest in the specialty, reflect on meaningful clinical experiences, and demonstrate awareness of the challenges and innovations in neurological care.
Clinical and Professional Competence
Strong performance during neurology rotations and core clerkships is crucial. Programs look for candidates with sound clinical judgment, reliability, teamwork, and the ability to manage complex, evolving patient scenarios. Consistently strong evaluations and demonstrated initiative during rotations are highly valued.
Letters of Recommendation
LORs from U.S.-based neurologists or academic physicians are especially important. The most impactful letters highlight your intellectual engagement, diagnostic reasoning, patient-centered approach, and potential to contribute meaningfully to a neurology training environment.
Personal Statement and Career Goals
Program directors seek candidates who show thoughtful, long-term commitment to neurology. Whether your interests lie in stroke, epilepsy, neuroimmunology, movement disorders, or academic medicine, your goals should align with the program’s strengths and values. A personal statement that reflects both introspection and clear motivation helps distinguish your application.
Team Compatibility and Program Culture
Neurology involves multidisciplinary collaboration and continuity of care. Directors pay close attention to your ability to work well with peers, respect for other disciplines, and willingness to learn from others. Being personable, adaptable, and respectful enhances your appeal as a future colleague.
USMLE Step Scores
Step 2 CK remains a significant factor. Many programs use it to differentiate among candidates with similar academic and clinical backgrounds. A competitive score demonstrates strong clinical knowledge and preparation for residency. Step 3 is not required but can add value, especially for international graduates applying to H-1B–sponsoring programs.
Performance in Neurology Rotations
Evaluations from neurology electives or sub-internships, especially at U.S. institutions, give programs insight into how well you’ll perform in residency. Strong feedback on your diagnostic skills, work ethic, and eagerness to learn can be a decisive factor.
Demonstrated Commitment to Neurology
Candidates who have shown sustained interest through clinical exposure, research, shadowing, or involvement in neurology interest groups are ranked more favorably. Programs want to train residents who are excited to contribute to the field long-term.
Research and Scholarly Activity
Research is particularly valued in neurology, especially in areas such as neuroscience, neuroimaging, neurodegeneration, and clinical trials. While not mandatory, research experience shows academic curiosity and enhances your application, especially at university-based programs.
Professionalism Throughout the Application Process
Every interaction reflects your professionalism, from emails and interview punctuality to follow-up communication. Respectful and clear communication with faculty, coordinators, and peers signals your readiness for the responsibilities of residency.
Diversity of Experience and Perspective
Neurology programs appreciate applicants with unique life experiences, including international backgrounds, career transitions, community service, or leadership roles. Diverse perspectives enrich the training environment and patient care.
Geographic or Institutional Ties
Some programs prioritize applicants with a demonstrated interest in their geographic area or institutional mission. If you have lived, studied, or worked in a certain region, or have family there, mention it in your application materials or interviews.
Here it is again,
You made it all the way to the end of this blog post!
We hope you have found the information offered here by IMG Rotations useful in your neurology residency match journey.
Don't forget to check our blog post on the ERAS residency match 2026 HERE.
Any questions? Email us: info@imgrotations.com
