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Preference Signaling in General Surgery: A Qualitative Study of Program Director Perspectives.

Pooja M Varman1, Nicole E Brooks1, Judith C French2

  • 1Digestive Diseases Institute, Cleveland Clinic, Cleveland, Ohio.

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PubMed
Summary

Program directors (PDs) use preference signals to identify interested applicants, especially borderline candidates, but interpretation varies. Increasing signals may improve utility and reduce overapplication in general surgery residency selection.

Keywords:
general surgeryinterview selectionmatch processpreference signalingprogram directorsresidency applications

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Area of Science:

  • Medical Education
  • Surgical Residency Selection
  • Applicant Evaluation

Background:

  • Large-scale surveys provide some data on preference signal usage in general surgery programs.
  • Little is known about how program directors (PDs) interpret and apply these signals in practice.
  • Understanding PDs' perspectives is crucial for optimizing the resident selection process.

Purpose of the Study:

  • To gather in-depth insights from PDs on their perspectives of preference signaling.
  • To understand how PDs interpret and apply preference signals in the resident selection process.
  • To explore the impact of preference signals on general surgery residency applications.

Main Methods:

  • Semi-structured virtual interviews were conducted with 14 PDs from diverse general surgery programs.
  • Interviews explored PDs' perceptions, impact, benefits, challenges, and recommendations regarding preference signals.
  • Transcripts were analyzed thematically to identify trends in signal interpretation and application.

Main Results:

  • Preference signals are perceived to reflect genuine applicant interest and help borderline candidates stand out.
  • PDs use signals for interview selection but not post-interview ranking; their absence doesn't always signal lack of interest.
  • Increasing the number of signals is supported by PDs to potentially reduce overapplication and enhance signal utility.

Conclusions:

  • Preference signaling can foster a more applicant-centric review process, particularly for less competitive applicants.
  • Variability in PDs' signal interpretation presents challenges for equitable advising.
  • Standardization and transparency are needed as general surgery transitions to more signals to ensure equitable outcomes.