Elemosho Abdulaziz, Sarac Benjamin A, Janis Jeffrey E
From the Department of Plastic and Reconstructive Surgery, College of Medicine, The Ohio State University Wexner Medical Center, Columbus, OH.
Plast Reconstr Surg Glob Open. 2025 Jul 18;13(7):e6981. doi: 10.1097/GOX.0000000000006981. eCollection 2025 Jul.
Preference signaling was introduced in 2021 to address application inflation and improve applicant-program alignment in residency selection. This study examined its impact on residency application data across several specialties.
Data from the Electronic Residency Application Service and the National Resident Matching Program for presignaling (2020-2022) and postsignaling (2022-2024) eras were analyzed. Metrics, including number of applicants, applications per applicant, signals offered, and match rates, were compared using mean differences.
Among specialties offering 10 or more signals, ear, nose, and throat and neurosurgery had the highest reductions in the mean number of applications per applicant (-23.8% and -12.8%, respectively), whereas orthopedics and dermatology had the lowest reduction (-7.8% and -0.1%, respectively). Anesthesiology and obstetrics and gynecology both saw increases in the number of applications per applicant (+5.8% and +2.2%, respectively). Ear, nose, and throat; anesthesiology; orthopedic surgery; and neurosurgery all had a concurrent increase in match rates over the same period. Among specialties offering fewer than 10 signals, plastic surgery showed the largest reduction (-18.2%) in applications per applicant, followed by emergency medicine (-14.7%), family medicine (-7.6%), and pediatrics (-0.4%). Internal medicine and general surgery saw increases in applications per applicant (+7.2% and +9.7%, respectively). Plastic surgery, pediatrics, and family medicine all had concurrent increases in match rates over the same period.
Preference signaling may have reduced application inflation and improved match rates, however, shifts in application trends following the COVID-19 pandemic may have confounded these. Ultimately, time and how programs choose to use preference signaling will determine how preference signaling reshapes these application data.
2021年引入了偏好信号，以应对申请人数膨胀问题，并在住院医师选拔中改善申请人与项目的匹配度。本研究考察了其对多个专业住院医师申请数据的影响。
分析了来自电子住院医师申请服务系统和国家住院医师匹配计划在预信号阶段（2020 - 2022年）和后信号阶段（2022 - 2024年）的数据。使用均值差异比较了包括申请人数量、每位申请人的申请数、发出的信号数和匹配率等指标。
在提供10个或更多信号的专业中，耳鼻喉科和神经外科每位申请人的平均申请数减少幅度最大（分别为-23.8%和-12.8%），而骨科和皮肤科减少幅度最小（分别为-7.8%和-0.1%）。麻醉科以及妇产科每位申请人的申请数均有所增加（分别为+5.8%和+2.2%）。同期，耳鼻喉科、麻醉科、骨科手术和神经外科的匹配率均有所提高。在提供少于10个信号的专业中，整形外科每位申请人的申请数减少幅度最大（-18.2%），其次是急诊医学（-14.7%）、家庭医学（-7.6%）和儿科学（-0.4%）。内科和普通外科每位申请人的申请数有所增加（分别为+7.2%和+9.7%）。同期，整形外科、儿科学和家庭医学的匹配率均有所提高。
偏好信号可能减少了申请人数膨胀并提高了匹配率，然而，COVID-19大流行后申请趋势的变化可能混淆了这些结果。最终，时间以及项目选择如何使用偏好信号将决定偏好信号如何重塑这些申请数据。
