Thread by @steve_pletcher

Approaching a new application cycle! Students asking “What do I need to know about Preference Signaling?” Signaling going live in 15 specialties, anticipated to impact > 80% of applicants (and their advisors!). Here’s the skinny on Signaling 1/21 #MedEd #Match2023 #MedTwitter

How does signaling work? Applicants are provided with a set number of signals (determined by specialty) and send these signals – generally through ERAS – to programs of particular interest. Programs see only a list of applicants who have sent them a signal 2/21

At its core, preference signaling simply allows applicants a credible method to inform programs of their interest. This happens early, 𝗕𝟰 𝗶𝗻𝘁𝗲𝗿𝘃𝗶𝗲𝘄 𝗼𝗳𝗳𝗲𝗿𝘀 – there is no match to align applicant/program interests & most applicants screened out in this phase 3/21

Signaling allows applicants to be noticed by their programs of interest and programs to focus on applicants who are more likely to match with them. In OHNS, both applicants (85%) and programs (90%) favor continuing the process – a rare win/win proposition 4/21

Who is participating? Most specialties are participating through an ERAS Supplemental program bit.ly/3DzCXEy. # of signals varies widely among specialties: Ortho will use 30 signals while Derm will use 3. We’ll get back to how this impacts the process … 5/21

In OHNS (5 signals), A signal increased the likelihood of receiving an interview offer by >250%. Applicants who struggle most to receive interview offers received the biggest % boost when adding a signal. Full data in this open access pub bit.ly/3az8E33 6/21

Because signals are so impactful, applicants must make consequential decisions early in the process. To do this well, identify programs that interest you and determine if these programs are likely to look favorably upon your application. 7/21

When choosing your favorite programs, remember that NOBODY but you sees your list of signals, so you don’t need to worry about how others view your program preferences 8/21

You do, however, need good intel on how you will be viewed as an applicant. This is HARD and having an advisor that gives you the real scoop rather than a “you’re great” assessment is critical 9/21

Cross ref your advisors input with the NRMP tool bit.ly/3iZbYJ0 but recognize that this data is only current through 2020. Get input from PGY 1&2s who have recently experienced the process! 10/21

Many specialties provide confidential virtual mentoring resources – take advantage of these! My specialty’s (OHNS) is here bit.ly/3NWEauH Especially critical for applicants from schools without a home program 11/21

Good news is that applicants have demonstrated that they can make good signaling choices – 250% increase in interview offer rate with signals shows us applicants are on target 12/21

Learn the specifics of your specialty’s process: Are you able/expected to signal your home school? How about those where you completed a visiting SubI? This varies between specialties 13/21

In many programs, ERAS preference signaling is part of a supplemental application that also includes separate Geographic Interest and Meaningful Experiences domains 14/21

I favor rule preventing signal to home program. Decision about signaling home program can be thorny: if your primary advocates learn that you’re not so interested in their program will it impact advocacy? 15/21

Signaling also serves as a step to potential bigger changes in the application process – we’re already seeing this with high signal specialties like Ortho (30) and OB/GYN (18) 16/21

The more signals a specialty provides, the more signaling resembles an application cap, but with training wheels as there is no hard cut-off. Excellent arguments for cap in blog/tweets of @jbcarmody likely to be another win/win for applicants & programs 17/21

In the first year of OHNS signaling, approx. 60% of applicants matched at home or one of 5 signals – simulates an application cap of six. With majority of students matching with app cap of six, do we really need students applying to 85 programs? 18/21

Will be interesting to see % of applicants that match at signal or home program in Ortho and OB/GYN. I expect it will be close to 100% and finally provide an escape from “application fever” @jbcarmody 19/21

Low signal # specialties retain traditional preference signaling impact – students increase interview invite likelihood at programs of their interest while maintaining similar opportunities without signals 20/21

That’s it for now; props to SIGNALING PARTNERS @DrCWDavidChang @Sonyamcna & Marc Thorne, #meded LUMINARIES @Maya_Michigan, @ilanarosman and the Tweeter who brought me to Twitter @Bob_Wachter BTW this thread is COVID related - Signals = one of many COVID driven med innovations