How aspiring radiology residents can win the ‘application arms race’
Experts are sharing advice on how aspiring residents can win today’s “applications arms race” in diagnostic and interventional radiology.
There has been a “notable” uptick in competition for resident positions across these two specialties in recent years. A total of 2,227 applicants vied for just 1,162 positions available in diagnostics and another 479 for 188 openings in interventional imaging, researchers detailed Wednesday in the Journal of the American College of Radiology [1].
To try and increase their chances, applicants have begun blanketing programs with submissions, a phenomenon some have dubbed the “applications arms race” or “application fever.” On average, aspiring radiologists submitted 72 applications in DR and 37 in IR for the 2024 match, according to the Electronic Residency Application Service.
“This has been compounded by the advent of virtual interviewing, where there is no financial burden of actually visiting programs, which previously constrained some widespread applying,” Dhairya A. Lakhani, MD, an assistant professor with the West Virginia University School of Medicine, and colleagues wrote Aug. 28. “The surge in both applicants and applications per applicant has led to congestion in the candidate selection process for interviews. Residency selection committees find it challenging to review all applications thoroughly, resulting in difficulty in considering all interested candidates adequately.”
To help counteract “interview congestion,” program directors have suggested using “preference signaling” to help inform them if an applicant is genuinely interested in the institution. In the 2023 cycle, there was a 58% interview rate with signaled U.S. radiology residency programs versus 9% in those without.
A survey found that about 70% of candidates favored this new system, Lakhani and co-authors noted. In response, 184 of 187 radiology resident programs have now adopted this approach. The system allows candidates to submit 12 “signals” via a tiered system, with six designated as “gold” choices (the most preferred) and six more as “silver” (preferred).
“The tiered system aimed to distribute signals evenly, with gold signals identifying top programs and silver signals providing more flexibility. However, due to subjective biases and varying perceptions of the signal types by candidates and programs, their implementation is challenging and creates anxiety for both applicants and program leadership in the absence of objective data,” the authors noted. “Hence, this study aims to assess the impact of the new gold and silver program signals on interview rates, examine how applicants used signals based on their application's competitiveness, and gauge applicants' perceptions of program signals as of the 2024 application cycle.”
For the study, Lakhani et al. sent a survey to radiology residency applicants in the 2024 cycle who registered with RadRoom, a centralized platform for accessing resources and hosting events related to the match process. They sought to gather information about applicants’ background, signal distribution and interview outcomes.
A total of 202 applicants completed the survey for a 28% response rate. Most of them applied to diagnostic radiology, and nearly all used six gold signals (98%) and six silver (97%). Interview invitation rates were “significantly” higher for signaled programs (60%) when compared to those without (9%) (the rate at the comparator nonsignaled programs was 37%). Gold signaled programs had much higher interview rates at 68% when compared to 52% in silver. Respondents used 49% of their signals for “likely to match” programs, 33% for “aspirational” programs and 18% for “safety” programs, the authors noted. Most (76%) said they wanted to see this signaling option continue in future match cycles.
Lakhani and colleagues offered three take-home points from their analysis:
- Program signals significantly boosted interview rates, with gold signals proving more effective than silver.
- A recommended strategy for signal use based on match likelihood is to allocate about three gold and three silver signals to "likely to match" programs, two gold signals to "aspirational" programs, and a mix of one gold and three silver signals to "safety" programs.
- Most survey respondents either agreed or strongly agreed that program signals were helpful in the residency application process and supported continuing the signaling program for the radiology residency application process.
“Our survey provides insights on how applicants used their allocated six gold and six silver signals based on perceived application competitiveness,” the authors advised. “This information is valuable for prospective applicants planning their approach and for programs aiming to understand how applicants utilize their signals, which can guide their strategies for inviting applicants.”
Marty Stempniak has covered healthcare since 2012, with his byline appearing in the American Hospital Association's member magazine, Modern Healthcare and McKnight's. Prior to that, he wrote about village government and local business for his hometown newspaper in Oak Park, Illinois. He won a Peter Lisagor and Gold EXCEL awards in 2017 for his coverage of the opioid epidemic.