Introduction: Program signaling (PS), which enables residency applicants to signal their preference for a specific program, was introduced in emergency medicine (EM) in the 2022–2023 residency application cycle. In this study we evaluated EM program directors’ (PD) utilization of PS in application review and ranking. This study also explores the relationship between program characteristics and number of signals received as well as the relative importance and utilization of signals related to the number of signals received.
\nMethods: This is an institutional review board-approved, cross-sectional study of PDs at Accreditation Council for Graduate Medical Education-accredited EM residency programs. We used descriptive statistics to describe the characteristics of residency programs and practices around PS. Measures of central tendency and dispersion summarized continuous variables. We used chi-square analysis or the Fisher exact test for comparisons between groups for categorical variables. Comparisons for continuous variables were made using the t-test for independent samples or analysis of variance.
\nResults: The response rate was 41% (n = 113/277 EM programs). Most programs participated in PS
(n = 261/277 EM programs, 94.2%). Mean number of signals received was 60 (range 2–203). Signals received varied based on program characteristics including geographic location and program type, duration, environment, and longevity. Most used PS in holistic review (52.2%), but other uses varied by proportion of applications that were signaled. The importance of PS in application review (mean 2.9; 1–5scale,1= not important, 5 = extremely important) and rank list preparation (2.1) was relatively low compared to other application elements such as standardized letters of evaluation (4.97 for review, 4.90 for ranking).
Conclusion: The study provides insights into PS utilization in EM’s inaugural year. We have identified patterns of signal use based on program characteristics and number of signals received that can inform signal allocation and utilization on an individual applicant and program level. A more nuanced understanding of signal use can provide valuable insight as the specialty of EM grapples with fluctuations in its applicant numbers and shifting demographics of its applicant pool.
","language":"eng","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"program signaling"},{"word":"signaling"},{"word":"preference signaling"},{"word":"program signals"},{"word":"residency application"}],"section":"Education","is_remote":true,"remote_url":"https://escholarship.org/uc/item/8wd5d0tn","frozenauthors":[{"first_name":"Alexis","middle_name":"E.","last_name":"Pelletier-Bui","name_suffix":"","institution":"Cooper University Hospital/Cooper Medical School of Rowan University, Department of Emergency Medicine, Camden, New Jersey","department":""},{"first_name":"Timothy","middle_name":"","last_name":"Fallon","name_suffix":"","institution":"Maine Medical Center, Tufts University School of Medicine, Department of Emergency Medicine, Portland, Maine","department":"Emergency Medicine"},{"first_name":"Liza","middle_name":"","last_name":"Smith","name_suffix":"","institution":"University of Massachusetts Chan School of Medicine, Baystate Medical Center, Department of Emergency Medicine, Springfield, Massachusetts","department":"Emergency Medicine"},{"first_name":"Tania","middle_name":"","last_name":"Strout","name_suffix":"","institution":"Maine Medical Center, Tufts University School of Medicine, Department of Emergency Medicine, Portland, Maine","department":""},{"first_name":"Michelle","middle_name":"","last_name":"Fischer","name_suffix":"","institution":"Penn State College of Medicine/Penn State Health Milton S. Hershey Medical Center, Department of Emergency Medicine, Hershey, Pennsylvania","department":"Emergency Medicine"},{"first_name":"Mark","middle_name":"","last_name":"Olaf","name_suffix":"","institution":"Geisinger Commonwealth School of Medicine, Department of Emergency Medicine, Scranton, Pennsylvania","department":""},{"first_name":"Erin","middle_name":"","last_name":"McDonough","name_suffix":"","institution":"University of Cincinnati College of Medicine, Department of Emergency Medicine, Cincinnati, Ohio","department":"Emergency Medicine"},{"first_name":"Brian","middle_name":"","last_name":"Barbas","name_suffix":"","institution":"Loyola University Chicago, Stritch School of Medicine, Loyola University Medical Center, Department of Emergency Medicine, Maywood, Illinois","department":"Emergency Medicine"},{"first_name":"Michael","middle_name":"","last_name":"Cirone","name_suffix":"","institution":"University of Illinois, Department of Emergency Medicine, Chicago, Illinois","department":"Emergency Medicine"},{"first_name":"Elizabeth","middle_name":"Barrall","last_name":"Werley","name_suffix":"","institution":"Penn State College of Medicine/Penn State Health Milton S. Hershey Medical Center, Department of Emergency Medicine, Hershey, Pennsylvania","department":""}],"date_submitted":"2024-02-03T00:57:54.783000Z","date_accepted":"2024-04-19T18:40:58.287000Z","date_published":"2024-08-27T13:00:00Z","render_galley":{"label":"Final Article","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/19392/galley/25986/download/"},"galleys":[{"label":"Layout","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/19392/galley/23863/download/"},{"label":"Final Article","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/19392/galley/25986/download/"}]}