A residency application feature that allows applicants to express targeted interest in a program is growing in popularity. Since the feature was first used in 2020 as part of the otolaryngology application process, program signaling—which allows applicants to indicate interest in a limited number of residency programs—has expanded rapidly.
During the 2023–2024 residency-selection cycle, signaling was used by 22 physician specialties. A recent webinar, hosted by the Association of American Medical Colleges (AAMC), examined trends related to program signaling across multiple specialties. The webinar included residency faculty members from a number of specialties that used program signals during the 2022-23 cycle—obstetrics and gynecology, orthopaedic surgery, dermatology and emergency medicine—speaking on the efficacy and lessons learned from the early stages of program signaling usage.
For applicants looking to make the most of their signals in the upcoming 2023-24 cycle—with the caveat that the program signaling process is still evolving and data may change—the webinar offered a few key insights.
State geographic preferences
In addition to the program signaling option, the MyERAS application offers supplemental questions that are related to an applicant’s preferred geography. Those optional questions communicate the importance of geography for an applicant and provide an opportunity to share preferences for regions and urban, suburban, and rural settings.
As an applicant, data shows that geographic preference may be key in securing an interview. A survey conducted by the AAMC during the 2022-23 residency selection cycle, 3 found that 59% of program director respondents agreed that geographic preferences helped them identify applicants they would have otherwise overlooked.
The strength of signals coupled with other factors was highlighted in results from the anesthesiology and pediatrics residency selection processes, presented by Dana Dunleavy, PhD, the AAMC’s director of residency selection and admissions programs. The key takeaway for applicants: When using signals, the highest likelihood of interview invitations in anesthesiology and pediatrics occurred when an applicant signaled a program and the applicant’s geographic preference aligned with program location. That trend can be applied across most specialties that participated last cycle, Dunleavy said.
The AMA Road to Residency series provides medical students, international medical graduates and others with guidance on preparing for residency application, acing your residency interview, putting together your rank-order list and more.
Not all signals are equal
A program signal doesn’t guarantee an interview. AAMC data from the 2021-22 cycle —the most current data available, in most cases—found that 10% of programs received over 20% of available signals. Programs may use signals differently based on the number of signals they receive, as well as other factors.
“It’s important for both programs and applicants to understand that signaling is just one of many factors in an application,” said Nicole Karjane, MD, director of the obstetrics & gynecology residency program at Virginia Commonwealth University Health System. “For programs one of the things that they have to see is there is going to be variation from program to program on the signal number that each is getting and the weight that is placed on it. For applicants, know that not every program you signal is going to give you an interview. That has been a misconception, especially the first year [of signaling].”
Consider signaling home programs
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The AAMC recommendation is that applicants should signal their home institution and institutions with which they did away rotations if those rank among their top choices.
It’s worth noting that a signal, on its own, isn’t the strongest indicator of a match. In an applicant survey following the 2021-22 residency-selection process 21% of dermatology applicant respondents matched at a program to which they sent a signal, 39% matched at a program with which they did an away rotation, and 25% matched with their home institution.
No online resource contains as much information as FREIDA™, the AMA’s comprehensive residency and fellowship database®, which includes more than 12,000 Accreditation Council for Graduate Medical Education-accredited residency programs, and offers a streamlined user experience.
The platform offers any user who has signed in the ability to personalize searches and nickname them so that search filters don’t need to be reapplied every time. AMA members also have the ability to take notes on programs, conduct side-by-side program comparisons, and use FREIDA’s Residency Calculator to help plan ahead for residency application expenses.
Efficacy spans applicant type
Program signaling is optional. Across all specialties, however, applicants who signal have a stronger chance of landing an interview slot, according to the data presented during the webinar.
That was true across all applicant types, including osteopathic medical students and international medical graduates (IMGs). Historically, IMGs have been less inclined to answer geographic preference questions on the MyERAS application. The correlation between geographic preference and signal efficacy may cause some to rethink that.
