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The Impact of Preference Signaling on Orthopedic Surgery Residency Interviews
Kathryn Radulovacki1, Sophia Kocher1, Brooke E Schroeder1
1Department of Orthopedic Surgery, Duke University School of Medicine, Durham, North Carolina.
Journal of Surgical Education
|July 16, 2026
Summary
Preference signaling significantly increases orthopedic surgery residency interview offers. The effectiveness of these signals remains consistent across different program types and sizes, emphasizing their importance in applications.
Area of Science:
- Medical Education
- Surgical Residency Admissions
- Applicant Strategy
Background:
- Preference signaling is a tool used by medical students applying to residency.
- Understanding the impact of preference signaling on interview offers is crucial for applicants and programs.
Purpose of the Study:
- To determine if preference signaling effectiveness for orthopedic surgery residency interview offers varies by program type and size.
- To analyze the impact of signaling on interview offer rates across different academic and community programs.
Main Methods:
- Retrospective cohort study of 2024 orthopedic surgery applicants using AAMC data.
- Analyzed interview offer rates based on program type (academic/community) and size (small, medium, large).
- Statistical evaluation using Kruskal-Wallis and Dunn post hoc tests.
Main Results:
- Applicants signaling a program received interview offers significantly more often (22% vs. 1%, p < 0.001).
- No significant difference in interview offer rates was found based on program type, size, or combined factors for signaled applicants.
- Similarly, no significant differences were observed for applicants who did not signal.
Conclusions:
- Preference signaling's impact on interview offers is consistent across orthopedic surgery residency program types and sizes.
- Not signaling a program significantly reduces the likelihood of receiving an interview offer.
- Strategic use of preference signals is vital for residency applicants.
