Rafetto Anessa N, Granberg Candace F, Koo Kevin
Department of Urology, Mayo Clinic, Rochester, Minnesota.
Department of Urology, Mayo Clinic, Rochester, Minnesota.
J Surg Educ. 2025 Jul;82(7):103542. doi: 10.1016/j.jsurg.2025.103542. Epub 2025 May 15.
Rising annual volumes of urology residency applications have increased applicants' expenses and program faculty's time costs. A "large-volume" preference signaling initiative that was introduced in the 2024 residency match, in which applicants may "signal" their interest in up to 30 programs, has the potential to reduce excess application volumes. We aimed to characterize changes in urology residency application volumes and model the financial impact to residency applicants and programs following implementation of large-volume preference signaling.
Using public data from the Association of American Medical Colleges and American Urological Association, we analyzed urology residency application and interview volumes during 2013 to 2024 and modeled preinterview costs during 2017 to 2024. To model applicants' costs, we calculated submission fees for the total applicant pool annually. For program costs, we assumed that submitted applications undergo 2 rounds of faculty screening and that large-volume preference signaling permits programs to halve the initial screening pool. All costs were adjusted for inflation.
From 2013 to 2023, the average number of applications submitted per applicant increased by 66% (53 to 83 applications). In 2024, large-volume preference signaling decreased submitted applications by 25% to 66 per applicant, while average interviews given by programs and taken by applicants remained unchanged. In the cost model, large-volume preference signaling resulted in applicants' average submission costs decreasing by 31% per applicant and programs' review costs decreasing by 25% per program. The total cost of application submission and review decreased by 26% from $3.05 million to $2.25 million, corresponding to a per-vacancy cost of $5,836, the lowest cost observed during the study period.
Implementation of large-volume preference signaling resulted in markedly decreased urology residency application volumes and program review time, resulting in substantially lower total costs of the submission and review process.
泌尿外科住院医师申请量逐年上升，增加了申请人的费用以及项目教员的时间成本。2024年住院医师匹配中引入的一项“大量申请”偏好信号倡议，申请人可以对多达30个项目“表明”兴趣，这有可能减少过多的申请量。我们旨在描述泌尿外科住院医师申请量的变化，并模拟大量申请偏好信号实施后对住院医师申请人和项目的财务影响。
利用美国医学院协会和美国泌尿外科学会的公开数据，我们分析了2013年至2024年期间泌尿外科住院医师的申请量和面试量，并对2017年至2024年期间的面试前成本进行了建模。为了模拟申请人的成本，我们计算了每年总申请人池的提交费用。对于项目成本，我们假设提交的申请要经过两轮教员筛选，并且大量申请偏好信号使项目能够将初始筛选池减半。所有成本都进行了通货膨胀调整。
从2013年到2023年，每位申请人提交的平均申请数量增加了66%（从53份申请增加到83份申请）。2024年，大量申请偏好信号使每位申请人提交的申请减少了25%，降至66份，而项目提供的平均面试次数和申请人接受的平均面试次数保持不变。在成本模型中，大量申请偏好信号导致每位申请人的平均提交成本降低了31%，每个项目的评审成本降低了25%。申请提交和评审的总成本从305万美元下降了26%，降至225万美元，对应每个空缺职位的成本为5836美元，这是研究期间观察到的最低成本。
大量申请偏好信号的实施导致泌尿外科住院医师申请量和项目评审时间显著减少，从而使提交和评审过程的总成本大幅降低。
