A residency-application feature that allows medical students to express targeted interest in a program is growing in popularity. Since the feature was first used in 2020 as part of the otolaryngology application process, program signaling—which allows applicants to indicate interest in a limited number of residency programs—has expanded rapidly.
During the 2024–2025 residency-selection cycle, signaling was used by at least 27 physician specialties. The program-signaling process is still evolving and the data on its use is still being gathered. For applicants looking to make the most of their signals in the upcoming 2025–2026 residency-selection cycle, the data available so far on the process does offer a few key insights.
Geographic preference matters … to an extent
In addition to the program-signaling option, the MyERAS application offers supplemental questions that are related to an applicant’s preferred geography. Those optional questions allow applicants to state their geographic preferences by picking up to three of the nine U.S. Census Bureau divisions where they would prefer to do their residency training.
Preliminary data collected by the Association of American Medical Colleges during the 2024–2025 Match cycle found that “in general, interview-invitation rates are higher for applications with aligned geographic preferences, followed by no geographic preference, and unaligned geographic preferences. The effect is smaller than what is observed for program signals.”
When a residency applicant signals a program in one of their preferred geographic regions, that is likely to make program directors take the most notice.
AMA member Deborah Clements, MD, chairs the National Resident Matching Program (NRMP) Board of Directors and is a family medicine residency program director. In an interview ahead of the 2024–2025 residency-application cycle, Dr. Clements indicated that the signals that get the most attention tend to originate from “those candidates that come from places where I wouldn't expect. We have an adage: ‘There's no such thing as bad weather, only bad clothing.’ And so it really does help us to pin down those people who have a true interest.”
The AMA Road to Residency series provides medical students, international medical graduates and others with guidance on preparing for residency application, acing your residency interview, putting together your rank-order list and more.
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Not all signals are equal
A residency program signal doesn’t guarantee an interview, and some specialties value signals more than others. A 2024 survey from the National Resident Matching Program (NRMP) examined how program signals influenced residency-application review and selection processes across 21 physician specialties. When asked whether receipt of program signals changed their review and selection process, responding program directors in these specialties had the highest instance of saying yes.
- Diagnostic radiology—100% of responding program directors indicating signals changed their process.
- Anesthesiology—92.3%.
- Otolaryngology—90%.
- Obstetrics & gynecology—82.1%.
- Dermatology—81.8%.
Other specialties such as pathology (in which 60% of respondents said signals changed their process 60%), neurology (58.1%), general surgery (56.7%) and child neurology (50%) relied less heavily on signals.
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Remember: signals don’t make a Match
While the 2024 NRMP survey found that signals can play a significant role in applicant screening and interview invitations, just 15.8% of responding program directors said they were a factor in how programs selected applicants for inclusion in their rank-order list.
Laurie Curtin, PhD, is the NRMP’s chief operating officer. During an episode of the “AMA Making the Rounds” podcast, she said that any correlation between signals and ranking behavior is unclear because there have been few changes in rank-order list length in the program signaling era.
“Lots can happen between the summertime, when the majority of applicants will start to put their applications together and the specialties they're interested in and the programs that they're interested in. But a lot can happen over the course of the interview, the interview trail, and where they apply and interview may fundamentally change their perspective by the time they're ready to rank,” Curtin said.
No online resource contains as much information as FREIDA™, the AMA’s comprehensive residency and fellowship database®, which includes more than 13,000 Accreditation Council for Graduate Medical Education-accredited residency programs, and offers a streamlined user experience.
The platform offers any user who has signed in the ability to personalize searches and nickname them so that search filters don’t need to be reapplied every time. AMA members also have the ability to take notes on programs, conduct side-by-side program comparisons, and use FREIDA’s Residency Calculator to help plan ahead for residency-application expenses.
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Don’t overthink it
While signals may carry different weight across specialties and applicant type, the general advice is to use them on programs for which you have genuine interest and a realistic chance of matching.
“Use your signals to express your true interest at the time of your application,” Dr. Clements said. “We understand it's just the beginning of the process. And you're operating under assumptions just like we are. You may choose to rank us further down your list or not at all once you get through the process. But signaling sends us an intention that might increase your odds of being offered an interview.”
