Radiology Residency Selection in the Era of Program Signals: A National Survey of Interview Selection and Ranking...

To assess radiology residency program leadership perspectives on factors influencing interview selection and final ranking during the 2025-2026 Match, emphasizing preference signals, letters of intent, visiting rotations, virtual interviews, and academic metrics.

A cross-sectional anonymous survey was distributed to program directors of ACGME-accredited Diagnostic Radiology and Interventional Radiology-Integrated residency programs participating in the 2026 Residency Match. Program directors were asked to complete the survey and distribute it to individuals involved in applicant interviewing or ranking. Items assessed program characteristics, application review factors, preference signals, letters of intent, visiting rotations, and interview format perceptions. Descriptive statistics were used, with exploratory subgroup comparisons performed using chi-square or Fisher's exact tests.

The final analytic cohort included 85 respondents. The most highly weighted interview selection factors were first-attempt pass on USMLE Step 1/COMLEX Level 1, USMLE Step 2 CK/COMLEX Level 2 CE score, and Gold/Silver preference signals, rated highly considered or essential by 90.6%, 88.2%, and 87.1%, respectively. For final ranking, overall interview impression was rated highly considered or essential by 94.1% and selected among the most significant factors by 91.8%. Letters of intent had limited overall influence, although 35.3% reported ranking an applicant higher because of one. Visiting rotations positively influenced ranking for 77.6%. Fully virtual interviews were used by 91.8%, but 44.7% reported a negative effect on applicant evaluation.

Standardized examination performance and preference signals strongly influence interview selection, whereas interview performance dominates final ranking. Away rotations remain influential, while letters of intent appear most impactful in closely contested ranking decisions.