Preference Signaling for General Surgery Residency: How Should Applicants Use Signaling?

Preference signaling was introduced for general surgery in the 2021-2022 virtual recruitment cycle. Despite guidance from the Association of American Medical Colleges, how applicants and programs used and interpreted signals varied greatly. We set out to assess how applicants utilized their allotted signals.

An institutional review board-approved anonymous online survey was distributed to applicants interviewing at a single large academic institution for the Match 2022. Using Likert-type scales, applicants were asked to rate their agreement with a variety of statements regarding perceptions of fit for signaled and nonsignaled programs.

44 survey responses were received (37% response rate), and 50% (n = 22) came from applicants using fit for guide their preference signaling. 36% of applicants signaling for fit agreed that virtual recruitment improved their perceptions of fit for signaled programs versus 32% of applicants not signaling for fit (P = 0.751). Regarding nonsignaled programs, 50% of applicants signaling for fit agreed that virtual recruitment improved their perceptions of fit versus 23% of applicants not signaling for fit (P = 0.060). More applicants not signaling for fit disagreed that their perceptions of fit for nonsignaled programs improved throughout the cycle compared to applicants signaling for fit (32% versus 5%, P = 0.019).

Perceptions of fit for signaled and nonsignaled programs improved for applicants who based their signaling on fit, but not necessarily for applicants using other strategies. Signaling is an important tool for applicants as it increases their odds of being interviewed; further research is needed to fully understand its role in recruitment for general surgery and to best advice applicants.