Session Design Submission Review

Yes

• CoSEF
• Surgical Education Research

Preference signaling was first implemented in the resident recruitment process in the 2021-2022 match as an attempt to provide an objective metric for program directors (PDs) to identify applicants highly interested in their program while decreasing interview hoarding, which had been highly prevalent since the transition to virtual interviews in 2020. In 2024, the Association for Program Directors in Surgery (APDS) increased the number of signals per applicant from 5 to 15. In an attempt to study the impact of this change, the Surgical Education Research Committee (SERC), Graduate Surgical Education Committee (GSEC), and the Collaboration of Surgical Education Fellows (CoSEF) undertook several research projects this past year, funded by the ASE, to investigate PD, medical student advisor, and applicant experiences with and attitudes toward the current preference signaling system. These mixed methods studies involved semi-structured interviews with the aforementioned stakeholder groups, qualitative thematic analysis, followed by a survey of general surgery PDs and applicants based on the themes identified. 

While many commonalities between groups were noted, such as a common understanding of the purpose of preference signaling and a need for greater transparency regarding how programs are using signals, stakeholder opinions diverged in key areas, such as how applicants should be allocating their signals and attitudes toward home or visiting sub-interns signaling their home institution. These results highlight a need for discourse between stakeholder groups with respect to the future of preference signaling. Therefore, we propose a preference signaling panel at ASE this year. Panelists will include program directors, medical school advisors, and general surgery residents from both community and academic programs, as well as a representative from the APDS signaling task force. This panel will start with a summary of the APDS signaling task force and SERC/GSE/CoSEF signaling working group findings, followed by a panel discussion of these results. The panel discussion will be structured around common themes identified in previous preference signaling work, aiming to provide pragmatic guidance on: how general surgery residency applicants should determine their competitiveness and allocate their signals, how general surgery program directors can approach interpreting signals to improve efficiency in application review, how many signals per applicant is the ideal number, how much transparency general surgery programs should provide to applicants regarding how they use signals, whether home and visiting sub-interns should signal their home or visiting institutions, and how the approach to signaling may vary for applicants who are international medical graduates, DO students, couples matching, or dual applying. The discussion will highlight where stakeholder perspectives align or diverge.

This signaling panel represents a unique integration of three major stakeholder vantage points (PDs, applicants, and medical student advisors) and will provide a holistic understanding of preference signaling. Such cross-stakeholder discourse is critical to shaping an inclusive, transparent, and evidence-driven future for surgical recruitment.

Describe the evolution and current state of preference signaling in general surgery recruitment

Examine findings from studies of applicants, medical student advisors, and program directors attitudes about and experiences with preference signaling, noting areas of convergence and divergence between stakeholder groups

Discuss the ideal future of preference signals from the perspective of applicants, medical student advisors, and program directors

Highlight differences in preference signaling for applicants that are international medical graduates, DO students, couples matching, or dual applying