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Preference Signaling During the 2025 Urology Residency Match: Applicant and Program Director Perspectives
Ellen M. Cahill, MD, Aleksandra Golos, BS, Olamide Olawoyin, MD, Ankur U. Choksi, MD, Piruz Motamedinia, MD, Joshua Sterling, MD, MSc, Marianne Casilla-Lennon, MD.
Yale University School of Medicine, Department of Urology, New Haven, CT, USA.
Introduction: Application numbers in the urology match have increased in recent years. Preference signaling (PS), introduced in 2021, was designed to facilitate matching by allowing applicants to express interest in specific programs and ultimately limit application numbers. We aimed to evaluate how applicants and programs viewed the signaling process in the 2025 cycle.
Methods: Two anonymous, web-based surveys– one for applicants and one for program directors (PDs) – were distributed by email to assess views regarding the PS process.
Results: A total of 251 applicants and 53 PDs responded to the surveys. Applicant and PD demographics are detailed in Tables 1 and 2. Applicants applied to a median of 46 programs and received 14.5 interview offers, of which 12 were from programs they signaled. 95% of applicants matched at a program they signaled. Programs received a median of 114.5 signals and interviewed 40 applicants. PDs used signals to guide initial applicant screening and interview selection. Over 70% of PDs reported signals impacted their interview offers “a lot” or “a great deal.” Overall, 87% of applicants and 68% of PDs were satisfied with the number of signals allotted.
Conclusions: Both applicants and PDs were satisfied with the current signaling process. PS plays a large role in the evaluation of an applicant from a PD perspective. PS has reduced the number of applications per applicant, and may help programs determine a specific applicant’s interest in their program.
Table 1. Applicant Survey Responses (N=251) | | | |
| Variable | | Median (IQR) / n (%) |
| Gender | | |
| Male | | 133 (53.0%) |
| Female | | 109 (43.4%) |
| Non-binary | | 3 (1.2%) |
| Prefer not to say | | 6 (2.4%) |
| Race | | |
| Asian | | 52 (20.7%) |
| Caucasian/White | | 151 (60.2%) |
| Native American/Pacific Islander | | 1 (0.4%) |
| African American/Black | | 17 (6.8%) |
| Other | | 8 (3.2%) |
| Prefer not to say | | 22 (8.8%) |
| Hispanic/Latino | | 28 (11.2%) |
| Region of Medical School | | |
| New England | | 17 (6.8%) |
| Mid-Atlantic | | 48 (19.1%) |
| Midwest | | 59 (23.5%) |
| South | | 73 (29.1%) |
| West | | 30 (12.0%) |
| Non-US | | 19 (7.6%) |
| Unknown | | 5 (2.0%) |
| Number of Away Rotations | | 2 (2,3) |
| Number of Programs Applied To | | 46 (35.5, 62.5) |
| Number of Signals Sent | | 30 (30, 30) |
| Number of Interview Offers | | 14.5 (9, 19) |
| Interview Offers from Signaled Programs | | 12 (7.5, 17) |
| Number of Interviews Attended | | 13 (8, 16) |
| Number of Programs Ranked | | 13 (8, 16) |
| Matched (yes) | | 214 (85.3%) |
| Number matched on rank list | | 2 (1, 4) |
| Matched at: | | |
| Home Program | | 36 (16.8%) |
| Away Rotation program | | 88 (41.1%) |
| In-person interview program | | 113 (45.0%) |
| Signaled program | | 203 (94.9%) |
| Signal Satisfaction | | |
| Satisfied | | 219 (87.3%) |
| Wanted more signals | | 10 (4.0%) |
| Wanted fewer signals | | 16 (6.4%) |
Table 2. Program Director Survey Responses (N=53) | | | |
| Variable | | Median (IQR) / n (%) |
| AUA Section | | |
| New England | | 8 (15.1%) |
| Mid-Atlantic | | 5 (9.4%) |
| New York | | 1 (1.9%) |
| Northeastern | | 5 (9.4%) |
| North Central | | 10 (18.9%) |
| Southeastern | | 10 (18.9%) |
| South Central | | 5 (9.4%) |
| Western | | 9 (17.0%) |
| Number of Signals Received | | 114.5 (70.25, 152) |
| Interviews Offered | | 40 (35.25, 47.5) |
| Interviews Offered to Applicants who did NOT signal the program | | 0 (0,4) |
| How much does an applicant sending a preference signal to your program impact your decision to interview them? | | |
| Not at all | | 2 (3.8%) |
| A little | | 1 (1.9%) |
| A moderate amount | | 9 (17.0%) |
| A lot | | 11 (20.8%) |
| A great deal | | 28 (52.8%) |
| Which of the following ways did you utilize preference signals during the application cycle? | | |
| Initial review of applications | | 43 (81.1%) |
| Determining who to offer interviews to | | 33 (62.3%) |
| Deciding who to rank/where on list to rank | | 5 (9.4%) |
| Satisfaction with Signals | | |
| Satisfied | | 36 (67.9%) |
| Applicants should have fewer signals | | 6 (11.3%) |
| Applicants should have more signals | | 3 (5.7%) |
| There should be no signaling | | 3 (5.7%) |
| Matched Applicants | | |
| Matched home applicant | | 20 (37.7%) |
| Matched sub-intern | | 37 (69.8%) |
| Matched applicant who signaled | | 45 (84.9%) |
| Matched applicant who did not send signal | | 4 (7.5%) |
| Matched via SOAP/scramble | | 2 (3.8%) |
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