Signals and Preferences: Experiences of Midwest Family Medicine Residencies

Family medicine implemented program signals and geographic and setting preferences in the 2023-2024 residency application cycle. We performed a qualitative study with the following aims: (a) describe residency program experiences with implementation of signaling and preferences; and (b) identify opportunities for applicants, advisors, residency leadership, and policymakers to optimize these two programs.

This qualitative study used the RE-AIM framework (reach, effectiveness, adoption, implementation, and maintenance) to guide interviews of family medicine program faculty from the Midwest United States between January and April 2024. We analyzed data using a thematic analysis.

We interviewed 21 faculty members. About half of respondents somewhat or strongly agreed that program signals (10, 48%) and geographic and setting preferences (11, 52%) added value to the current system. We identified four themes: (1) Faculty adopted signals and preferences strategically to complement their existing application review strategies; (2) Signals were perceived as reducing application volume and burden; (3) Signals did not impact diversity and equity, but geographic preferences may benefit community health; (4) Modifications to signals and preferences are recommended to optimize use in family medicine.

Program faculty implemented signals and preferences into holistic review to reduce application review burden. Signals and preferences should support the unique experiences of family medicine residencies and needs for primary care physician workforce development. Future research should focus on refining signals and preferences and their impact on match outcomes and Supplemental Offer and Acceptance Program participation rates.