Can Preference Signaling Streamline the Applicant Selection Process?

In the 2022 match cycle preference signaling was introduced to general surgery. For 3 years (2022-2024) each applicant was able to use 5 signals to indicate a preference for a program. In 2024, the average number of ranked programs among applicants was 12 demonstrating that programs were creating their interview list beyond those who signaled. For the 2025 match cycle, the number of signals rose to 15 which allowed our program to review and offer interviews to only those applicants who signaled a preference. We compare the key demographics of applicants for the 2023, 2024 and 2025 match cycle to see if there was a difference with this approach.

At our academic medical center, to create our interview list, each year we holistically review approximately 300 applications using a scoring rubric, with each application reviewed by the PD or APD, and a second faculty member. In 2023, 761 applications were screened by a diverse group of faculty in a labor-intensive process to reach the 300 applications. In 2024, the group of 300 was created partially from those who signaled (148) with the balance selected again by a diverse group of faculty. In 2025 the entire list was created from applicants who signaled us, eliminating entirely this first step in our screening. To evaluate differences in the approaches, we looked at the following variables in each of the groups selected for holistic review: gender, race, geographic region of medical school, reviewer score and step 2 score. We performed chi squared analysis for the categorical variables and t-test for continuous variables using R. ANOVA analysis was used when comparing continuous variables for all 3 groups RESULTS: There was no significant difference in the demographics of applicants that underwent holistic review between the 3 years. In 2024, there was no difference in demographics of holistically reviewed applicants between faculty chosen applicants and applicants who preference signaled.

Using signals only as a method to screen applicants saved a step in the review process without affecting the demographics of applicants. Preference signaling can be a valuable tool to streamline the interview selection process with little impact on the quality and demographics of the group.