Preference Signaling in Ophthalmology: Inferences and Recommendations
By Avery Zhou, BA, MA
Key Takeaways:
Preference signaling in ophthalmology is new, but signaling data from the AAMC can guide strategy.
Signal programs to get interviews you wouldn’t have gotten otherwise.
Don’t focus on sending signals to programs to be ranked higher on their rank list.
Send at least one signal to your “safety” program.
Preference signaling was first introduced by ENT in 2021, was positively received by applicants and programs, and is now a new addition to the ophthalmology application cycle this 2024-2025 cycle. Speculation surrounds how applicants can best utilize this new tool and although we aren’t sure how exactly preference signaling will be utilized in ophthalmology, we have access to data from other specialties to make some reasonable predictions. Here’s what we know, and what we can infer:
What we know
All applicants this year receive 7 equally-weighted preference signals to express particular interest in programs. Official match guidelines from the AAO and AUPO have specified that students, if interested in the programs, also need to send signals to home programs and programs they completed away rotations at. Each program will decide for itself how, when, and whether to use signals during the cycle.
What we infer
We can use 2023-2024 data from the PM&R match to guide us, as PM&R had the most similar characteristics to ophthalmology with 105 participating residency programs, 1,055 applicants, and 5 signals per applicant in 2024 (in comparison to ophthalmology, with approximately 121 participating residency programs, 917 applicants in 2024, and 7 signals per applicant).
Findings from the PM&R match suggested that sending a signal significantly increased interview invitation rates by almost a factor of 4 (43% vs 11%) compared to not signaling. The AAMC also gave specific recommendations for programs to use signals only when deciding whom to invite to interview with the understanding that applicants’ interest in programs may change after application submission for many reasons. Although ophthalmology does not have a similar recommendation this year, signaling will likely play a larger role in deciding who to interview than in deciding how to rank. Therefore, it would be in the applicants’ best interest to signal programs for the primary purpose of securing an interview. This could be signaling a program you feel qualified or overqualified for but the seriousness of why you are interested in the program is not clear, or signaling a program you feel qualified for but the interview is not guaranteed and a signal may tip you into the interview pile. Although there will be variation among programs, it seems that signals would generally best be used to secure as many interview opportunities as possible.
Image source: Exploring the Relationship Between Program Signaling & Interview Invitations Across Specialties 2024 ERAS® Analysis Data as of 2/28/2024, Association of American Medical Colleges
It’s also important to consider how other applicants will likely send their signals. The AAMC reported that specialties which incorporate few preference signals (7 or less) saw an average of 24% of all signals sent to 10% of programs. We see a similar pattern in 2024 data from the PM&R match, with 22% of all signals sent to the top 10% programs. Although it’s not revealed which specific programs received the most signals, we can infer that they are programs with the highest prestige and/or in the most desirable locations. Knowing this, you may strategically choose to signal programs that may not receive as many signals so that your signal carries more weight and is more likely to result in an interview. It would also be a good idea to send a signal to at least one of your “safety” programs; the cost of going unmatched is much steeper than going undermatched, so be sure to cover your bases!
Image source: Program Signal Data Excel sheet, under 2024 MyERAS® Content Research Updates
It’s also important to consider how other applicants will likely send their signals. The AAMC reported that specialties which incorporate few preference signals (7 or less) saw an average of 24% of all signals sent to 10% of programs. We see a similar pattern in 2024 data from the PM&R match, with 22% of all signals sent to the top 10% programs. Although it’s not revealed which specific programs received the most signals, we can infer that they are programs with the highest prestige and/or in the most desirable locations. Knowing this, you may strategically choose to signal programs that may not receive as many signals so that your signal carries more weight and is more likely to result in an interview. It would also be a good idea to send a signal to at least one of your “safety” programs; the cost of going unmatched is much steeper than going undermatched, so be sure to cover your bases!
Conclusions
At this point, programs are still largely undecided on how they plan to utilize signals. However, by extrapolating data from a specialty with a similar signaling profile, signaling will likely significantly improve your chances of receiving an interview and may be most impactful when used toward less popular programs that would otherwise not send an interview invitation due to perceived lack of interest. In addition to strategy, however, signaling should ultimately also reflect your true preferences. By incorporating this advice with your personal preferences, you can improve your chances of successfully matching into a program where you will genuinely be happy.
Avery Zhou, BA, MA
Avery joined the RWO educational team in the spring of 2024. She is a 4th year medical student at the Kirk Kerkorian School of Medicine at the University of Nevada, Las Vegas, who is currently in Houston completing a research gap year at Retina Consultants of Texas. Avery is applying for ophthalmology and is passionate about improving access to resources and opportunities for students interested in ophthalmology. In her free time, Avery enjoys spending time with her newly-adopted toothless dog, Eevee, and playing competitive video games with her husband.
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