Use of Preference Signals in Family Medicine Residency Recruitment

Increases in graduate medical education application volume led to the introduction of preference signaling-a tool within the Electronic Residency Application Service that allows applicants to signal their sincere interest to a limited number of programs. This study aims to evaluate how family medicine program directors used preference signals during the 2023-2024 recruitment season, the first year this tool was available to family medicine programs. Understanding program director perspectives on preference signal utility is crucial for determining the tool's impact on the residency selection process.

Data were collected through the Council of Academic Family Medicine Educational Research Alliance survey, which was distributed to Accreditation Council for Graduate Medical Education-accredited US family medicine residency program directors and included questions on preference signaling. We performed statistical analysis using χ2 testing and multivariable logistic regression to assess the association between preference signal use and aspects of resident recruitment.

The overall response rate to the question set was 308/767 (40.2%). Program directors generally used preference signals as a component of holistic review, which did not supersede factors such as applicant rotation experiences and geographic location preferences as influential to application review. Overall, preference signals did not significantly influence interview offers or applicant ranking.

Preference signals have been incorporated into the family medicine residency application review process but did not become a primary determinant in applicant selection during family medicine's first year of utilization. Traditional factors such as rotation performance and geographic preference remain highly influential. Further research is needed to optimize the use of preference signals in family medicine residency recruitment.