Program Signals and Interview Invitations: Insight Into Recent Updates to the OTO-HNS Residency Application Process

Introduction: In recent years, numerous changes have been made to the residency application process. Amongst these changes is the introduction of “program signals” through which an applicant can demonstrate specific interest in a residency program. While students in the 2023 match were allowed 7 program signals, this number increased to 25 for the 2024 match with the goal of reducing the overall application volume. Given these changes, it is important for students and advisors to understand the new role of signals in the OTO-HNS residency application process.

Methods: An anonymous REDCap questionnaire was sent to all current OTO-HNS program directors in January 2024 to assess the number of applications, number of interviews, number of signals, and perceived importance of signals. Data were summarized using R Version 4.3.1.

Results: After 11 days of data collection, 33 (26%) of program directors had completed the survey. While programs received a median (IQR) of 417 (376, 447) applications last year, this year they reported receiving 300 (243, 336) applications of which approximately 103 applicants (~36%) signaled the program. While the overall percent of applicants who were interviewed by a program was approximately 16%, the percent of interviews among applicants who had signaled the program was approximately 39%. Of all interviews conducted by a program, approximately 98% were of applicants who had signaled the program. Finally, 29 (88%) of program directors reported feeling that signaling played an important role in deciding to interview a candidate and, when asked to rank the importance from 1-100, the median score was 94 (80, 99).

Conclusions: Program signals play an important role in a residency program’s decision to interview a candidate. We found that nearly all students who were chosen for an interview by a program had signaled that program. These findings suggest that the implementation of signals successfully decreased the average number of applications received by each program by 27% and that medical students applying to more programs than available signals may experience diminishing returns.