Preference Signaling for General Surgery Residency: How Should Applicants Use Signaling?

Introduction: Preference signaling was introduced for general surgery in the 2021-2022 vir-tual recruitment cycle. Despite guidance from the Association of American Medical Col-leges, how applicants and programs used and interpreted signals varied greatly. We set out to assess how applicants utilized their allotted signals.Methods: An institutional review board-approved anonymous online survey was distributed to applicants interviewing at a single large academic institution for the Match 2022. Using Likert-type scales, applicants were asked to rate their agreement with a variety of state-ments regarding perceptions of fit for signaled and nonsignaled programs.Results: 44 survey responses were received (37% response rate), and 50% (n = 22) came from applicants using fit for guide their preference signaling. 36% of applicants signaling for fit agreed that virtual recruitment improved their perceptions of fit for signaled programs versus 32% of applicants not signaling for fit (P = 0.751). Regarding nonsignaled programs, 50% of applicants signaling for fit agreed that virtual recruitment improved their percep-tions of fit versus 23% of applicants not signaling for fit (P = 0.060). More applicants not signaling for fit disagreed that their perceptions of fit for nonsignaled programs improved throughout the cycle compared to applicants signaling for fit (32% versus 5%, P = 0.019). Conclusions: Perceptions of fit for signaled and nonsignaled programs improved for appli-cants who based their signaling on fit, but not necessarily for applicants using other strategies. Signaling is an important tool for applicants as it increases their odds of being interviewed; further research is needed to fully understand its role in recruitment for general surgery and to best advice applicants.(c) 2023 Elsevier Inc. All rights reserved.