How signaling is shaping the 2024-2025 Match season

With the 2024-2025 residency application cycle underway, many osteopathic applicants, medical faculty, student advisors and graduate medical education staff have questions about what signaling is and how it fits into the residency Match process.

I currently serve as the vice president for strategy and quality initiatives at the National Board of Osteopathic Medical Examiners (NBOME). I’ve worked closely with the Electronic Residency Application Service (ERAS) system. I’ve also worked with the American Association of Medical Colleges (AAMC) on the updated Residency Explorer™ tool, which includes information and guidance on signaling. This experience has allowed me to gain valuable insight into signaling and how it impacts the Match.

What is signaling?

As part of the residency application process, signaling is an emerging innovation intended to provide programs with the opportunity to review genuinely interested applicants during the interview selection process as part of holistic application review.

Signaling provides applicants with the opportunity to express genuine interest in programs at the time of application. For specialties and programs using signaling, it is accessible to all applicants at no additional cost.

These signals are sometimes referred to as program signals or preference signals. They are meant to be examined by programs as one aspect of a candidate’s application during a holistic application review.

A brief history of signaling

With the number of residency applications rising and programs having limited resources with which to review them, the resident selection process needed a new tool. The use of signaling in the residency application process developed over the last several years to address this need. Published studies in several specialties (including OB-GYN and orthopedic surgery) using program signals have shown promising results on their use in increasing the likelihood of interview invitation when compared to applicants who did not signal.

A December 2023 study of dermatology, general surgery-categorical and internal medicine-categorical programs participating in program signals in the 2022 ERAS application observed no negative impacts to a specific gender or underrepresented groups in medicine. As we are still in the early years of signaling and its use is growing and changing, research to better understand the impacts of signaling on the residency application process is ongoing.

How signaling works

A signal sent by an applicant will only be seen by that program, not by other programs to which a candidate has applied. Most specialties encourage applicants to signal the programs they are most interested in, regardless of home or away rotation, and to use all signals available to them.

A list of specialties that are participating in program signaling in the 2024-2025 residency application cycle is available on the AAMC website.

There are different approaches to program signaling, with participating specialties using different numbers of signals and a single-tier or two-tiered approach.

For participating specialties using two-tiered “signals,” i.e., gold versus silver, applicants distinguish between their most preferred choices. A “gold” signal indicates a program is most preferred by an applicant while a “silver” signal indicates a program is preferred. While sending a signal to a program doesn’t ensure an applicant will receive an invitation to interview, it has been shown to increase the likelihood of an interview offer.

How programs use signaling

The AAMC collected data from residency program directors at the completion of the 2024 season to understand how programs used signaling during the application process. They found:

• Roughly 70% of respondents to the survey agreed that program signals helped them identify applicants whom they would have otherwise overlooked.
• About half of respondents used signals as part of a holistic application review to decide whom to interview.
• Over 40% of respondents used signals as part of an initial screen, alongside other data, before conducting a holistic review.

New for the 2024-2025 Match cycle

For those applying to residency and fellowship programs in ERAS, a list of all participating programs can be found on the ERAS website. In addition, there are multiple resources to help applicants understand program signals and how to use them, including information on interview data and program signals in the Residency Explorer™ tool for the 2024-2025 cycle.

OB-GYN programs use a tiered signaling approach with three gold signals for programs of highest interest and 15 silver signals for programs of high interest. Guidance for applicants and their advisors on preference signaling is available online.

Specialties participating in non-NRMP matches—including ophthalmology, plastic surgery-independent and urology—are also using preference signaling. Due to the differences in how program signaling is used by each specialty, applicants should check a specialty’s recommendations regarding the use of program signals in this year’s application cycle.

Related reading:

How to soften red flags on your ERAS application

The top Match tips and advice from osteopathic physicians and students from the past year