Resident Selection in the Signaling Era: A Survey of General Surgery Program Directors

Area of Science:

• Medical Education
• Surgical Residency Recruitment
• Application Signaling Systems

Background:

• Preference signaling has evolved in residency recruitment.
• Transitioning from 5 to 15 signals per applicant aimed to refine the process.
• Understanding program director (PD) experiences is crucial for optimizing signaling systems.

Purpose of the Study:

• To characterize PD experiences and attitudes toward preference signaling post-transition to 15 signals.
• To determine the influence of program type and competitiveness on PD signaling experiences.
• To assess the impact of increased signals on application review efficiency.

Main Methods:

• An anonymous, voluntary electronic survey was distributed to 348 general surgery PDs in 2025.
• Survey items focused on PD experiences with preference signaling.
• Descriptive analysis was performed on the responses from 40 PDs.

Main Results:

• All surveyed PDs utilized signals in applicant review, with varied approaches (e.g., reviewing all signaled, only signaled, or using signals in scoring).
• A majority (61%) reported decreased application review time with signals; 15 signals further improved efficiency compared to 5.
• PDs rated the 15-signal system highly beneficial (applicants: 7.1/10, programs: 8.2/10) and supported its continuation, with 84% endorsing future transparency.

Conclusions:

• General surgery PDs employ diverse strategies for using preference signals in residency recruitment.
• The 15-signal system is viewed favorably, enhancing application review efficiency for over half of PDs.
• Future transparency regarding signal interpretation is essential for applicants and programs alike.