The Impact of Applicant Signaling on the General Surgery Match Process: A Single Institution Experience

Abstract

Objective

This single-institution study examined both the outcomes of signaling on the general surgery match and the perceptions of signaling by the applicants and the interviewers at an academic residency program.

Design

A retrospective review was performed using prospective data collected at a single institution over 2 application cycles that spanned 2022 to 2024. Applications were submitted through the Electronic Residency Application Service (ERAS). Statistical analysis was performed using Chi to square and logistic regression.

Setting

A tertiary academic medical center in the South.

Participants

Study participants were drawn from a pool of applicants in the general surgery residency program 2022 to 2024 application cycles. During this period, 2,421 candidates applied to this program and 155 (6.4%) signaled. Additionally, voluntary surveys were electronically distributed to the current and immediate past program directors, the chief residents involved in the interview process during this period, and the applicants who matched in 2024.

Results

Among applicants who signaled, those who were and were not interviewed exhibited no statistically significant differences in the United States Medical Licensing Exam (USMLE) Step 1 pass rate, gender, race/ethnicity, or medical school geographic region. Applicants who signaled were more likely to be interviewed, with a significantly higher interview rate, X2(1) = 187.42, p < 0.001, and 8.3 times higher odds of interviewing (95% CI 5.88-11.84). These applicants were also more likely to match at the program, with a significantly higher rate of matching, X2(1) = 38.25, p < 0.001, and 15.2 times higher odds of matching (95% CI 4.83-47.6). Lastly, among the applicants who signaled, multiple regression analysis was used to show that completion of a fourth-year rotation increased the odds of interviewing by 25 times (95% CI 2.73-228.44).

Conclusion

At this studied institution, the odds of interviewing and matching to this program were significantly higher for applicants who signaled. Multi-institutional studies are needed to validate the study findings.