Characterization of Applicant Preference Signals, Invitations for Interviews, and Inclusion on Match Lists for Residency Positions in Urology

Abstract

ImportancePreference signals were to be implemented in over 15 specialties during the 2022-2023 residency match. Analyzing results from the implementation of signals during the American Urological Association (AUA) urology match may inform future behavior.ObjectiveTo characterize applicant and program signal usage and results in the Society of Academic Urology and AUA databases with respect to interview invites and rank list creation.Design, Setting, and ParticipantsThis cohort study involved all applicants and residencies in the 2021-2022 AUA match with data analysis conducted in April through July 2022.ExposuresFive signals indicating interest.Main Outcomes and MeasuresUsing verified match and survey data reported by applicants and programs, a logistic regression was performed on applicant factors associated with obtaining an interview—the main outcome (using inclusion on rank list as a proxy): age, gender, degree (MD or DO), dispersal of signal, US senior status, racial minority group status, Latino ethnicity, international medical graduate status, presence of a home program, AUA geographic section, and US Medical Licensing Examination Step 1 score. Applicant signal dispersal strategies were stratified by applicant and program competitiveness, as well as program behavior upon receipt of signal with respect to extending interviews and rank list ordering of applicants.ResultsA total of 2659 signals were sent by 553 candidates (mean [SD] age, 27.4 [2.9] years; 179 female [32.4%], 243 racial minority candidates [61.2%]) submitting rank lists for 364 positions at 143 programs. Programs received a median (IQR) of 352 (295-411) applications and were signaled to a median of 16 (8-26) times each. In a logistic regression estimating interview status, geographic proximity (OR, 3.25; 95% CI, 2.05-5.15; P = .001) and signal status (OR, 6.04; 95% CI, 3.50-10.40; P < .001) were associated with receiving an interview. Using multiple imputation by chained equations to impute missing data and broadening the data set, male gender (OR, 0.64; 95% CI, 0.45-0.92; P = .04) and international medical graduate status (OR, 0.35; 95% CI, 0.15-0.81; P = .04) were negative variables, while MD degree (OR, 2.36; 95% CI, 1.27-4.36; P = .02) and US senior status (OR, 1.91; 95% CI, 1.13-3.23; P = .04) were positive variables.Conclusions and RelevanceThis study of the usage and trends of the newly added preference signals reported the most common strategies for signal dispersal; in an analysis of factors involved in obtaining an interview, geographic similarity between applicant and program and preference signal usage were associated with successful applications.

Preference Signaling Survey of Program Directors–After the Match

“…2,6,8 Similarly, in the 2022 to 2023 match cycle, urology applicants had sixfold increased chances of receiving an interview when a preference signal was sent to a program. 5 We report that within orthopaedic surgery, preference signaling is not only associated with increased likelihood of receiving an interview but also associated with being placed higher on a rank list. Based on our survey, 46.9% PD's demonstrated preference for individuals on their rank list who had signaled their program.…”

Understanding the Match: The Effect of Signaling, Demographics, and Applicant Characteristics on Match Success in the Orthopaedic Residency Application Process

“…Previous studies in other specialties have shown that, as expected, applications using a signal are more likely to result in an interview and a subsequent match. 3-6 They have also demonstrated that implementing signaling has decreased application numbers and resulted in a more even distribution of interviews. 3,7…”

“…Previous studies in other specialties have shown that, as expected, applications using a signal are more likely to result in an interview and a subsequent match. [3][4][5][6] They have also demonstrated that implementing signaling has decreased application numbers and resulted in a more even distribution of interviews. 3,7 As there are many factors that influence applicant success in securing interviews and matching at a desired program, it is important to analyze the effects of signaling in the context of other relevant applicant characteristics.…”

Error in Table, Abstract, and Results

“…In the Original Investigation titled “Characterization of Applicant Preference Signals, Invitations for Interviews, and Inclusion on Match Lists for Residency Positions in Urology,” 1 published January 20, 2023, the row labels in Table 1 for racial minority candidate, Latino candidate, IMG candidate, and home program were transposed—“No” should have appeared above “Yes.” Data from this table appeared in the Abstract and Results. Racial minority candidates should have appeared as 154 candidates (38.8%), and applicants that were MD students as 365 candidates (91.9%).…”

“…Racial minority candidates should have appeared as 154 candidates (38.8%), and applicants that were MD students as 365 candidates (91.9%). This article has been corrected …”