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Program signals are an easy opportunity for you to express particular interest in individual residency programs when you’re applying to residencies through ERAS.
You should use the maximum number of residency signals per specialty. They increase your likelihood of securing an interview, plain and simple. Program directors have reported as much for years. Plus, there’s no extra charge to use program signals.
Not every program participates in residency signals, and some use a tiered signaling system. I’m Dr. Mandalia, and I’ve helped hundreds of people like you navigate this process. Let’s explore the program signaling system in this article, and I’ll throw in some free expert tips along the way.
Watch our free Residency Specialty Spotlight videos to explore the daily life of residents in various specialties and hear practical advice for navigating the match process in each specialty.
How Program Signals Work
Also called preference signals, program signals tell participating residency programs that you are especially interested in their program — before interview invites go out. Programs consider signals as a major factor when deciding to whom they’re sending interview invitations.
The number of program signals you get to assign depends on the specialties you’re applying to. For example, pathology only allows you to assign signals to five individual programs, while orthopedic surgery lets applicants assign up to 30 program signals.
Some specialties (e.g., anesthesiology, dermatology, radiology, and internal medicine) also participate in tiered signaling, allotting applicants a certain number of “Gold” and “Silver” signals to assign to programs. Read more below about tiered signals.
Here’s a list of the number of signals you can send to programs in 2024 through ERAS, based on specialty, including how many tiered signals you can send.
Program signals are received at the institutional level by specialty. This means that if you choose to signal a program, it will apply to all the program tracks (preliminary, categorical, or advanced) for that given specialty at that institution.
Signals have been offered for about 5 years, and changes may be made each application cycle.
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Tiered Signaling (Gold vs. Silver)
For some specialties, you may use tiered signaling to indicate preferred vs. most preferred programs.
- A Silver signal means preferred, but not most preferred or highest interest.
- A Gold signal means the most preferred/highest interest.
If you choose to use tiered program signaling, the programs will see either “Gold” or “Silver” rather than just the “Yes” that comes with non-tiered signaling.
In 2023-2024, more than two-thirds of residency program directors interpreted Gold signals as more valuable than Silver. 29% said that they either did not differentiate between Gold and Silver signals or that they valued them equally.
How Programs View and Use Signals
Programs only see whether you signal their program. They cannot see other institutions where you signaled, and they cannot see other institutions where you didn’t signal.
If you signaled their programs, they see a “Yes” on your application. If you use tiered signaling, they will see either a “Gold” or “Silver” depending on what you selected.
More than 80% of programs view signals as a major factor when deciding who to invite for interviews.
Generally, programs use applicant signals as one way to determine which applicants to interview during the ERAS (Electronic Residency Application Service) season, but it is not the only way they sort through the large number of applications they receive.
Just like it’s optional for you to use them, programs have the option of whether or not to consider them. They also have the option to view the signals as either a major or minor consideration.
AMCAS (which administers ERAS) has instructed programs not to use signals as a screening tool by itself; however, there’s no guarantee that they don’t screen solely based on signals.
It’s possible that programs may use signals as tie-breakers for candidates with very similar stats. A 2024 report shows that one in four directors used signaling in tiebreaker situations between two candidates with equal competitiveness.
Note that some programs opt out of program signaling altogether. Here’s a list of residency programs that participate as of the current application cycle.
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Should You Use Program Signals?
The AAMC recommends that applicants use the maximum number of program signals allotted to them per specialty.
I agree that you should use the maximum number of signals. Two-thirds of program directors say signals are an “important” or “very important” factor when deciding whom to interview, so you’d be crazy not to use the program signals available to you.
Caveat: Only send signals to programs you’d actually accept an interview invitation from. Don’t waste your time trying to impress programs you’re not interested in.
In the 2023-2024 cycle, 9% of program directors opted out of using signals during holistic review — meaning students weren’t able to signal their program. That leaves 91% of PDs who did use signals, with two-thirds reporting that signals were either important or very important for their residency selection process.
The bottom line? Program signals are a super important component of your residency application, and you should use them strategically for the best results.
Home and Away-Rotation Programs
Should you signal programs where you did your home rotations and away rotations? In most cases, it is a good idea to send program signals to both the home and away-rotation programs you’re interested in.
You might think that spending a month of your time with them in medical school shows enough interest, but most program directors don’t see it that way. In 2023-2024, two-thirds of program directors encouraged applicants to signal their level of interest, “regardless of whether it was a home program or if you completed an away rotation here.”
However, the other 31% of PDs stated that students from their home institution don’t need to send a signal, as they often interview home applicants automatically.
If this applies to the home program you’re interested in, you can save your program signal for an external program. Just check with your home program beforehand to confirm their policy regarding home institution applicants.
As for away rotations, a large majority of program directors expect to see a program signal from former away students. Only 17% of program directors recommend that applicants who completed an away rotation withhold their program signal.
Check with your away rotation programs to see what their policy is, but when in doubt, send the signal to be safe.
Learn More: What’s the Average Residency Salary?
How Many Signals Does Each Specialty Get?
Each specialty gets a unique number of program signals you can send. Below is the information provided by the AAMC.
If you’re applying to multiple specialties, the number resets for each specialty. For example, you don’t have to stick to 5 signals between Emergency Medicine and Family Medicine specialties. You can signal 5 Emergency Medicine programs and 5 Family Medicine specialties.
| Residency Specialty | Number of Program Signals |
|---|---|
| Anesthesiology | 5 (Gold), 10 (Silver) |
| Child Neurology & Neurodevelopmental Disabilities | 3 |
| Dermatology | 3 (Gold), 25 (Silver) |
| Diagnostic Radiology and Interventional Radiology | 6 (Gold), 6 (Silver) |
| Emergency Medicine | 5 |
| Family Medicine | 5 |
| General Surgery | 15 |
| Internal Medicine | 3 (Gold), 12 (Silver) |
| Internal Medicine & Psychiatry | 2 |
| Neurological Surgery | 25 |
| Neurology | 8 |
| Orthopaedic Surgery | 30 |
| Otolaryngology | 25 |
| Pathology | 5 |
| Pediatrics | 5 |
| Physical Medicine and Rehabilitation | 8 |
| Psychiatry | 10 |
| Public Health and General Preventive Medicine | 3 |
| Radiation Oncology | 4 |
| Thoracic Surgery | 3 |
| Transitional Year | 12 |
Expert Tips for Signaling
Below are my expert tips for residency program signaling:
- Work with your med school faculty or resident mentors to determine which programs you should signal, as well as when you should utilize Gold and Silver signals.
- Align your signals with geographic preference. There’s evidence that a program signal combined with geographic preference may increase the number of programs that send you an interview offer.
- Max out how many signals you send. In the majority of cases, signaling increases your chances of getting an interview and matching with your ideal residency.
- Don’t use signals on safety programs unless 1) you’re genuinely interested and 2) you don’t have other programs you should signal instead.
- Don’t waste signals on reach programs when you need to give yourself an advantage at realistic programs. Mentors can help you determine what’s realistic.
- Don’t confuse the benefit of signaling. It’s primarily for increasing your chances of receiving an interview invite, not gaining admission. You still have to nail the residency interview.
Read Next: How Does Couples Match Work?
Other Ways to Indicate Interest
There are several ways to indicate your preferred residency programs throughout the residency application process, not just residency signaling.
Here’s a brief explanation of the four distinct ways to indicate special interest in residencies:
- Program signals are used during the initial residency application process to help you indicate your interest. Programs may or may not use this as part of their decision-making process for determining which applicants to interview.
- Letters of intent are an optional way to show one (and only one) program that, if they offer you acceptance, you will join their program — regardless of other offers. LOIs are sent after completing a residency interview with that particular program. Some programs will not accept letters of intent, so check before you send this binding letter.
- Letters of interest are another optional way to show your passion for a specific program. Unlike letters of intent, a letter of interest is non-binding, and you can send it to multiple programs that you’re honestly excited about. However, the benefit is significantly reduced due to the lower required commitment.
- The rank order list (ROL) is the last step in the NRMP Match process (after interviews are completed). You create an ROL to indicate your ordered program preference, allowing the NRMP (National Resident Matching Program) algorithm to match residency applicants with programs that also rank the applicant high, leading up to Match Week. Rank your preferred programs highest, and the algorithm will do the rest.
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FAQs
The most competitive residencies change with the times, but here are several factors that make a residency harder to get into:
- Residencies in more competitive specialties, like dermatology, neurosurgery, and ENT.
- Prestigious residencies, like Johns Hopkins, Mayo Clinic, and UC San Francisco.
- Programs in high-demand states, such as California, Massachusetts, and New York.
There are several red flags on a residency application that can’t be remedied by a signal alone, such as:
- Failed licensing exams (USMLE or COMLEX).
- Low amount of clinical hours or research experience.
- Disciplinary actions on the MSPE (AKA the Dean’s Letter).
- Underwhelming personal statement (please do not get AI to write it for you).
- Weak Selected Experiences section on the ERAS.
- Unexplained gaps in your CV.
- Multiple match cycle attempts.
If you have red flags on your ERAS application, a program signal can be part of your strategy to counteract the negative impression. Additionally, address any red flags in your personal statement and prepare professional responses for the residency interview.
Most recently, OB-GYN specialty applicants get a total of 18 tiered program signals to send: 3 Gold signals and 15 Silver signals.
Increase Your Chances of Matching to Your Dream Residency
Your medical education is too important to leave any stone unturned. Whether it’s residency signaling or interview prep, we’ve got you covered.
My fellow residency admissions advisors and I have helped thousands of medical students like you match into the residency of their choice. Boost your chances of matching to 97% when you use MedSchoolCoach admissions advising.
Amar Mandalia, MD
Dr. Mandalia is an accomplished medical writer with multiple manuscripts in peer-reviewed journals and a practicing GI physician in the Orlando area. He is the Admissions Advisor for MedSchoolCoach and has extensive experience helping students get into medical school and residency.
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