A relatively new aspect of a medical student’s physician residency application—program signaling, a system that allows applicants to indicate interest in a limited number of programs—has quickly become a key factor in the residency-selection process.
According to a 2024 survey from the National Resident Matching Program (NRMP), nearly 80% of responding program directors from specialties in which signaling was available said signals affected how they screen applications—and 70% said signals influence who gets an interview.
As applicants begin putting together their application packet for the 2026 Match cycle, here’s a few tips to create a strategy that allows for the most effective use of your signals.
Specialty specific strategy
According to the Association of American Medical Colleges, at least 27 physician specialties will use program signaling as part of their application process for the upcoming Match cycle. Of those specialties that use signaling, the system generally follows one of three models.
A lower signal number: This system typically allows applicants to send five or fewer signals, meaning that applicants should be highly strategic about how to use signals. Specialties that take this approach include radiation oncology (offering applicants four signals), pediatrics (five), pathology (five) and family medicine (five).
A two-tier system: This model allows applicants to send a mix of gold (strongest interest) and silver (strong interest) signals. The total number of signals can vary widely. NRMP data indicates that gold signals get more interviews, but silver signals still improve the odds of landing an interview over no signal. Specialties that take this approach include ob-gyn (three gold signals and 15 silver), anesthesiology (five gold, 10 silver) and internal medicine (three gold, 12 silver).
A high signal number: This format gives applicants a broad allocation of signals, often 20 or more. While it gives applicants more options for signals, it may dilute the efficacy of them in certain specialties. With higher signal availability it has become difficult to secure an interview invite from a program an applicant did not signal. This method is more common among surgical specialties including neurological surgery (25 signals) and orthopedic surgery (30 signals).
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How to use signals
According to data from the Organization of Program Director Associations, the top applicant factors for signaling were:
- Geographic preference.
- Career alignment.
- Proximity to family.
- Perceived interview likelihood.
- Program fit.
David Marzano, MD, is the director of the ob-gyn residency program at the University of Michigan. He advised students to find their priority in the Match and distribute their signals accordingly.
“We have some applicants from our medical school who have a partner who is already situated in a region,” said Dr. Marzano, an AMA member. If your partner is in California, and that’s where you want to focus your signals, you want to look at all the programs in that area. And this is where the signal might really come to the applicant’s benefit. In the past—before signals—if a very competitive applicant applied to a smaller community program a lot of those programs would have thought they were simply a backup and may not have even offered an interview.”
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Signals aren’t everything
Signals are only a data point. Most programs allow signaled applicants to get additional screening, and this may result in an interview. As far as ranking decisions further down the line, only 15% of program directors interviewed said that was a consideration.
Signals are a valuable tool but provide no guarantee. So to maximize your signals, Dr. Marzano, who also advises medical students in the run up to the Match, recommends applicants take an honest inventory of where they stand. Metrics such as performance on the United States Medical Licensing Examination (USMLE) Step 2 exam might make certain programs unrealistic.
There are also fit questions to consider.
“If you have no research publications and you're applying to a program that has a high value on research, you’re probably less likely to get an interview there,” he said. “Even more importantly that might not be the place where it's best for you to train, because if their focus is going to be on having their residents produce a lot of projects and papers and you hate doing research.”
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How to distribute signals
Signal distribution isn’t equal across all programs. This is most true in the specialties that have the fewest available signals.
Data from the 2024 Match cycle found that in general surgery (offering five signals), psychiatry (five) and pediatrics (five), 10% of signals were sent to more than 25% of programs. The distribution of signals to the top 10% of programs was closer to 15% in specialties offering a large number of signals.
Considering that a signal sent to programs that see fewer of them can carry more weight, Dr. Marzano advised applicants to take a conservative approach to the process.
“I’ll have very competitive students come in and their list will be the top 15 programs in the country,” he said. “Even if you're the top student, each of these programs are only going to take so many students. Going that route makes me nervous about your chances of matching.”
Signals, Dr. Marzano said, should be an expression of interest rather than an exercise in ambition.
“The best advice is to apply to schools that you align with—some that are realistic, some that stretch you. But don’t waste your signals on places that aren’t going to look at you seriously.”
