Preference Signaling in Plastic Surgery: A Survey of Applicants' Perceptions and Experience

Area of Science:

• Medical Education
• Surgical Residency Admissions
• Applicant Behavior Analysis

Background:

• Integrated plastic surgery residency is a highly competitive medical specialty.
• Applicant perspectives on preference signaling are crucial for understanding the residency match process.

Purpose of the Study:

• To explore applicant attitudes towards preference signaling in integrated plastic surgery residency applications.
• To identify factors influencing signal allocation, perceived effects on interviews and match outcomes, and rank list decisions.

Main Methods:

• Two surveys were administered to applicants during the 2024-2025 cycle: one pre-interview invitations and one post-rank list submission.
• Quantitative data were analyzed using descriptive statistics, and qualitative responses underwent thematic analysis.

Main Results:

• Nearly all surveyed applicants (97.5%) utilized all available preference signals.
• Geographic location, program culture, and subinternship experience were key factors in signal allocation.
• Applicants prioritized location, interview interactions, and perceived resident happiness when creating rank lists.

Conclusions:

• Preference signaling is prevalent and valued by applicants, yet program expectations and its true impact remain unclear.
• Standardized guidelines and increased transparency are necessary for fair and effective preference signaling in plastic surgery residency admissions.