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More Signals, Fewer Applications: Calibrating Preference Signaling for Residency Application
Taylor S Erickson1, Stephanie Younan2, Steven D Pletcher3
1is a Resident Physician, Department of Otolaryngology-Head & Neck Surgery, University of California, San Francisco, San Francisco, California, USA.
Journal of Graduate Medical Education
|August 15, 2026
Summary
Preference signaling in residency applications, especially with high signal counts, significantly reduces the number of applications submitted per applicant. This strategy also led to substantial cost savings across participating medical specialties.
Area of Science:
- Medical Education
- Residency Matching
- Application Process Optimization
Background:
- Preference signaling was introduced in the 2021 residency application cycle.
- It is now used by 27 specialties, expanding beyond indicating interest to mitigating overapplication.
Purpose of the Study:
- To assess how the number of allotted signals impacts application numbers across medical specialties.
- To evaluate the financial implications of preference signaling.
Main Methods:
- Cross-sectional analysis of US Electronic Residency Application Service (ERAS) data from 22 specialties (2022-2026).
- Specialties grouped by signal count: high (≥20), medium (8-19), low (≤7).
- Primary outcome: change in average applications per applicant; Secondary outcome: estimated financial impact.
Main Results:
- High-signal specialties (n=6) uniformly reduced applications per applicant (mean -28.3%).
- Medium and low-signal tiers showed mixed results, with some increases in applications.
- Overall, signaling yielded an estimated net cost reduction of $7,387,754, with high-signal specialties driving savings.
Conclusions:
- Preference signaling implementation has led to substantial reductions in application volume and associated costs.
- The high-signal approach reliably decreases the number of applications submitted per applicant.
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