More applications, fewer interviews—how preference signaling has impacted rad resident placements
Two years after the implementation of program preference signaling on radiology residency applications, a new analysis is shining light on how the change has impacted application outcomes.
Published in Academic Radiology, the paper details data from the Texas Seeking Transparency in Application to Residency (STAR) database. The analysis revealed that preference signaling can both help and hinder residents’ efforts to match.
“The addition of signals into the application process has coincided with a steep rise in the level of competitiveness of the DR specialty. From 2019 to 2023, the number of applications to DR residency positions increased from 1893 to 2409, representing a 5-year increase of nearly 4.2% annually. In 2023, the match rate of United States MD seniors was only 81%, making it the most competitive cycle since 2001,” Michael Phillipi, BA, with the department of radiological sciences at the University of California, Irvine, and colleagues explained. “With this increasing competition, candidates are motivated to strategize each component of their application to maximize their chances of securing a residency position.”
Since the implementation signaling, little data regarding its impact have been shared. To address this, the team reviewed the cases of 1,614 diagnostic radiology residency applicants from 2017 to 2024 in the Texas STAR database, enabling them to compare outcomes from both before and after preference signaling. The effect of signaling was assessed alongside applicants’ academic information, research productivity and their interview and match results.
The group found that signaling resulted in residents submitting additional applications, 10 more on average. The applicants who utilized signaling also received four fewer interview requests, though these individuals were ultimately deemed more likely to interview with and match at one of their programs of choice. Gold signals were statistically more beneficial than silver, though silver signals also increased the likelihood of residents landing interviews with their preferred programs.
“Despite their association with an increased total number of applications, signals demonstrated a positive impact on individual applications in our study,” the authors noted. “Applications that signaled a program were substantially more likely to receive interviews and match successfully, with ORs of 14.43 and 17.34, respectively. Nearly 71% of applicants who matched in the 2023 and 2024 cycle did so at programs they had signaled.”
Additional factors that increased the likelihood of a successful match were away rotations, geographic connections, honors on clinical rotations and higher Step 2 USMLE scores. Away rotations and geographic connections were the second and third most influential factors for receiving an interview and matching.
“Notably, our data revealed that applicants strategically paired these approaches, with 70.15% of applicants granting a signal to a program where they completed an away. Given only 8.03% of away rotations without a signal resulted in a match, there may be a complementary benefit from this dual expression of interest,” the authors suggested.
Overall, the group indicated signaling has given residents an edge on their applications, though it has not helped temper the issue of overapplying among radiology residents. This, the authors advised, should be considered in future discussions regarding the appropriate allotment of signals per resident.
Read more about the findings here.
In addition to her background in journalism, Hannah also has patient-facing experience in clinical settings, having spent more than 12 years working as a registered rad tech. She began covering the medical imaging industry for Innovate Healthcare in 2021.