Folkman Matthew J, Mihalic Angela, Sanford Christopher G
The University of Toledo College of Medicine and Life Sciences, Toledo, Ohio.
The University of Texas Southwestern, Dallas, Texas.
JB JS Open Access. 2025 Jul 24;10(3). doi: 10.2106/JBJS.OA.25.00036. eCollection 2025 Jul-Sep.
Residency programs have begun to offer preference signaling as a method for applicants to demonstrate commitment to programs. Orthopaedic surgery, which began signaling in 2022, allows applicants to use up to 30 signals. Early studies have evaluated the effects of signaling, demonstrating decreased application volume, varying effects on interviews, and high levels of applicant and faculty satisfaction. While the effects of signaling are beginning to be studied, multiple year evaluations are absent from the literature. The purpose of this study was to explore the impacts of signaling on the orthopaedic surgery match over its first two years.
We performed a retrospective cohort study using a prospectively collected database. The database contains survey data from 2017 to 2024 including applicants' demographics, academic performance, and application data. Applicants were first placed into cohorts comparing presignaling and postsignaling data. A second analysis organized applicants into the first year and second year of signaling. Cohorts were compared using descriptive statistics, chi-square tests, and independent samples -tests.
There were 1786 orthopaedic surgery applicants from 2017 to 2024. In the first two years of signaling, the mean applications decreased by 23 (p < 0.001), interview offers decreased by three (p < 0.001), publications increased by one (p < 0.001), and volunteer experiences decreased by one (p < 0.001). When compared with the first year, the second year of signaling decreased applications by 15 (p < 0.001), decreased interviews by one (p = 0.030), decreased volunteer experiences by four (p < 0.001), and decreased publications by one (p = 0.015). There was no significant difference in match rate.
Orthopaedic surgery preference signaling after two years significantly decreased mean applications, interview opportunities, and extracurricular experiences of applicants without affecting match success. These findings suggest that preference signaling continues to be an effective method at reducing application volume for programs and applicants while creating equitable opportunities for applicants after two years.
Level III-Retrospective Cohort Study. See Instructions for Authors for a complete description of levels of evidence.
住院医师培训项目已开始提供偏好信号，作为申请人展示对项目承诺的一种方式。骨科手术于2022年开始采用信号传递方式，允许申请人使用多达30个信号。早期研究评估了信号传递的影响，结果显示申请数量减少、对面试的影响各异，以及申请人和教员的满意度较高。虽然信号传递的影响已开始得到研究，但文献中缺乏多年评估。本研究的目的是探讨信号传递在其头两年对骨科手术匹配的影响。
我们使用前瞻性收集的数据库进行了一项回顾性队列研究。该数据库包含2017年至2024年的调查数据，包括申请人的人口统计学信息、学业成绩和申请数据。申请人首先被分为不同队列，比较信号传递前和信号传递后的数据。第二项分析将申请人按信号传递的第一年和第二年进行分组。使用描述性统计、卡方检验和独立样本检验对队列进行比较。
2017年至2024年共有1786名骨科手术申请人。在信号传递的头两年，平均申请数减少了23份（p<0.001），面试邀请减少了3次（p<0.001），发表文章数量增加了1篇（p<0.001），志愿者经历减少了1次（p<0.001）。与第一年相比，信号传递的第二年申请数减少了15份（p<0.001），面试减少了1次（p=0.030），志愿者经历减少了4次（p<0.001），发表文章数量减少了1篇（p=0.015）。匹配率没有显著差异。
两年后的骨科手术偏好信号传递显著降低了申请人的平均申请数、面试机会和课外经历，而不影响匹配成功率。这些发现表明，偏好信号传递仍然是一种有效的方法，可减少项目和申请人的申请数量，同时在两年后为申请人创造公平的机会。
III级——回顾性队列研究。有关证据水平的完整描述，请参阅作者指南。
