Reflections on Family Medicine's First Year of Program Signals and Other New ERAS Features

The 2023-2024 Electronic Residency Application Services® (ERAS®) cycle introduced program signals, geographic signals, and a revised experiences section to family medicine residency applications. This study explored how family medicine applicants, program directors (PDs), and medical student faculty advisors perceived the value of these new ERAS features.

We conducted semistructured interviews with 2024 National Resident Matching Program family medicine applicants, PDs, and advisors, all recruited through the American Academy of Family Physicians Student and Resident Initiatives program. Rapid qualitative analysis identified key themes from interviews.

Of 145 individuals contacted, 10 applicants, 11 PDs, and 10 advisors participated. Three key themes emerged: (1) the need for clearer communication, transparency, and standardized guidance from ERAS and programs; (2) signals were most useful as a tiebreaker, while geographic preferences were perceived as too broad to be meaningful; and (3) applicants were concerned about potential inequities in the new features, particularly for international medical graduates and those with less access to informational resources. Despite initial uncertainty, participants viewed signals as a promising tool for refining the match process. However, they emphasized the need for further data to assess long-term effects on applicant behavior, program selection, and equity.

While new ERAS features were perceived favorably overall, applicants, PDs, and advisors would like to see increased clarity and consistency in communications and implementation to alleviate applicant stress and ensure equitable and informed decision-making. Future research should explore signal distribution and interview conversion rates to further optimize the process.