From Application to Match: Evaluating the Impact of Tiered Signals in Interventional Radiology

Beginning in 2023, the tiered preference signaling system was introduced within the interventional radiology (IR) residency application process as a platform for applicants to effectively demonstrate program interest. Yet, the precise impact of signals on application outcomes has been underexplored. This study employs the Texas Seeking Transparency in Application to Residency (STAR) database to explore the impact of tiered preferential signaling (gold vs. silver signals) on match outcomes for interventional radiology residency.

Using the Texas STAR database, we retrospectively analyzed the data of 94 interventional radiology applicants from the 2023 and 2024 application cycles that had incorporated preferential signals. Outcomes were primarily assessed in terms of interview invites, applications resulting in matches, and the likelihood of interviews converting into successful matches. The number of interviews and match success odds were also analyzed across the demographics of gender and URiM (underrepresented in Medicine status). Odds ratios (OR), adjusted odds ratios (aOR), and confidence intervals were calculated as part of the statistical analysis.

Signal utilization overall imposed a strong, positive effect on the application cycle, with higher odds of receiving interviews (Odds ratios [OR] 6.30, p<0.001) and matching (OR 13.46, p<0.001). Specifically, gold signals were associated with a higher likelihood of receiving interviews (OR 9.66, p<0.001) and matches (OR 22.05, p<0.001) compared to silver signals (interview OR 4.69, p<0.001 and match OR 0.382, p = 0.509). Implementation of the tiered signals did not affect the total number of applications, and number of interviews for female vs. male applicants and URiM vs. Non URiM did not change.

Signals function as an effective tool for capturing applicants' interests in a specific program, ultimately enhancing the favorable odds of matching. Gold signals are associated with significantly elevated odds of application and match success. Therefore, prospective applicants must carefully delegate their allotted preferential signals to maximize their chances of a favorable match outcome.