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What Are Program Signals?
Program signals are an opportunity for you to express particular interest in individual programs when you’re applying to residencies. Not every residency program participates in signaling, but for many residencies, you can increase your chances of admittance with a well-placed signal.
Also called preference signals, program signals are received at the institutional level by specialty. This means that you cannot signal a specific program track while excluding other program tracks in the same specialty at the same institution. So, if you choose to signal a program, it will apply to all the program tracks (preliminary, categorical, or advanced) for that given specialty at that institution.
The number of program signals you get to assign depends on the specialties you’re applying to. Pathology, for instance, only lets you assign signals to five programs, while orthopedic surgery lets applicants assign up to 30 program signals.
Some specialties (anesthesiology, dermatology, radiology, and internal medicine) also participate in “two-tier” signaling, allotting applicants a certain number of “gold” and “silver” signals to assign to programs. Gold signals indicate the highest level of interest, while silver signals indicate a more moderate level of interest.
Here’s a list of the number of signals you can send to programs in 2024, based on specialty — including how many gold and silver signals you can send.
This program signal opportunity has been offered for about 5 years, and changes may be made each application cycle.
Programs Only See Your Signals to Them
Programs only see whether you signal their program. They cannot see other institutions where you signaled, and they cannot see other institutions where you didn’t signal.
Note that some programs opt out of program signaling altogether. Here’s a list of residency programs that participate as of the current application cycle.
Read Next: How to Write Your ERAS Personal Statement for Residency
Tiered Program Signaling
For some specialties, you may optionally choose to use tiered signaling to indicate preferred vs. most preferred programs.
- “Gold” means most preferred
- “Silver” simply means preferred
If you choose to use tiered program signaling, the programs will see either “Gold” or “Silver” rather than just the “Yes” that comes with non-tiered signaling.
In 2023-2024, 29% of residency program directors said that they either did not differentiate between gold and silver signals or that they valued them equally. More than two-thirds interpreted gold signals as more valuable than silver.
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How Signals Are Used
Program signals are just one piece of the holistic review process. Just like it’s optional for you to use them, programs have the option of whether or not to consider them.
Generally, programs use applicant signals as one way to determine which applicants to interview during the ERAS (Electronic Residency Application Service) season, but it is not the only way they sort through the large number of applications they receive.
In the 2023-2024 cycle, 9% of program directors opted out of using signals during application review, meaning students weren’t able to signal their program. That leaves 91% of PDs who did use signals as part of the application process, with two-thirds reporting that signals were either important or very important for their residency selection process. Furthermore, more than 1 in 4 directors said they use signaling in tiebreaker situations between two candidates with equal competitiveness.
Bottom line? Program signals are a super important component of your residency application, and you should use them strategically for the best results.
Should You Use Program Signals?
The AAMC recommends that applicants use the maximum number of program signals allotted to them per specialty. I agree. With two-thirds of program directors reporting that signals are an “important” or “very important” factor when deciding whom to interview, you’d be crazy not to use the program signals available to you.
That being said, also make sure that you’re only sending signals to programs you’d accept an interview invitation from. Don’t waste your time trying to impress programs you’re not interested in!
Should you send program signals to home programs or programs where you did an away rotation?
In most cases, yes – it is a good idea to send program signals to the home and away-rotation programs you’re interested in.
You might think that spending a month of your time with them in medical school shows enough interest, but most program directors don’t see it that way. In fact, in 2023-2024, two-thirds of program directors encouraged applicants to signal their interest, “regardless of whether it was a home program or if you completed an away rotation here.”
That said, 31% of PDs said that students from their home institution don’t need to send a signal, as they often interview home applicants automatically. If this applies to the home program you’re interested in, you can save your program signal for an external program. Just check with the home program beforehand to confirm their policy regarding home institution applicants.
As for away rotations, only 17% of program directors recommend that applicants who completed an away rotation withhold their program signal. This means that a large majority of program directors expect to see a program signal from former away students. Check with your away-rotation programs to see what their policy is, but when in doubt, send the signal to be safe.
Read Next: Important Factors In Residency Matching
The Best Way to Use Signals for Success in the Match
Work with your med school faculty or resident mentors to determine which programs you should signal, as well as when you should utilize gold and silver signals. There’s actually evidence that a program signal combined with geographic preference can increase the number of programs that send an interview offer.
It’s clear that, in the majority of cases, signaling increases your chances of getting an interview and matching with your ideal residencies.
Rank Order List vs. Letter of Intent vs. Program Signals
There are several ways to indicate your preferred residency programs throughout the residency application process. Here’s a brief explanation of the 3 distinct ways to indicate special interest in residencies:
- Program signals are used during the initial residency application process, and programs may or may not use this as part of determining which applicants to interview.
- A letter of intent is an optional way to show one (and only one) program that if they offer you acceptance, you will join their program — regardless of other offers. LoIs are sent after completing a residency interview with that particular program. Some will not accept letters of intent, so please check before you send them.
- The rank order list (ROL) is the very last step in the NRMP Match process (after interviews are completed). You create an ROL to indicate your ordered program preference after the interviews are all complete. This allows the NRMP to algorithmically match residency applicants with programs that also rank the applicant high. Student and program ROLs are used to pair residents with programs during Match Week.
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Amar Mandalia, MD
Dr. Mandalia is an accomplished medical writer with multiple manuscripts in peer-reviewed journals and a practicing GI physician in the Orlando area. He is the Admissions Advisor for MedSchoolCoach and has extensive experience helping students get into medical school and residency.
