Resident Selection in the Signaling Era: A Survey of General Surgery Program Directors
Year: 2026
Type: article
Study design: Observational Study
Abstract: OBJECTIVE: This study aimed to characterize program director experiences with and attitudes toward preference signaling after transitioning from 5 to 15 signals per applicant. This study also aimed to determine how program director experiences and attitudes were influenced by program type and competitiveness. DESIGN: An anonymous, voluntary survey was distributed in 2025 to all general surgery program directors with publicly available email addresses (n = 348). Survey items explored program director experiences with signaling. Descriptive analysis was performed. SETTING: Electronic survey administered to general surgery program directors. PARTICIPANTS: Forty PDs (55% university-based programs, 77.5% became PDs pre-signaling) completed the survey. RESULTS: All PDs used signals when reviewing applicants for interview: 42.5% reviewed all signaled applicants, 22.5% only reviewed signaled applicants, and 25% used signals as part of a scoring system to decide who to fully review. The majority of PDs (61%) felt that signals overall decreased application review time. Compared to 5 signals, 15 signals further decreased application review time and the number of applications fully reviewed. There were no statistically discernible differences in signaling practices by program type or competitiveness. All PDs supported the continuation of signaling, rating the current system of 15 signals as highly beneficial both to applicants (mean = 7.1/10) and programs (mean = 8.2/10). Further, while only about half (58%) of PDs were historically transparent regarding use of signals in application screening, the majority (84%) endorsed full transparency moving forward. CONCLUSIONS: In the 15-signal era, general surgery PDs used signals in a variety of ways during residency recruitment. PDs are supportive of the current signaling system, with more than half finding that the increase to 15 signals improved application review efficiency. Moving forward, transparency from programs will be crucial to ensure applicants understand how their signals are interpreted in the recruitment process.
Source: Journal of surgical education
Authors: Noosha D. Deravi, John M. Woodward, Connie Y. Gan, Nicole M. Santucci, Darci C. Foote, Caitlin Silvestri, Milanie Milan, Martha Godfrey, Jennifer H. Chen, Kirstyn E. Brownson, Jenny M. Guido, Benjamin D. Ferguson, Rondi Gelbard, Tasha Posid, Joseph C. L’Huillier, Emma G. Burke, Olabisi O. Sheppard, Nina W. Zhao, Erika Simmerman Mabes, Dylan R. Nieman, Colleen McDermott, Prajjwol Luitel, Jonathan T. Davies, Trenton Foster, Sarah Lund
Institutions: MedStar Georgetown University Hospital, Indiana University Indianapolis, Indiana University School of Medicine, University at Buffalo, State University of New York, Oregon Health & Science University, Washington University in St. Louis, Michigan State University, NewYork–Presbyterian Hospital, Columbia University Irving Medical Center, Columbia University, Duke Medical Center, University of Iowa, Baylor College of Medicine, University of Utah, Huntsman Cancer Institute, University of South Dakota, University of Michigan, University of Alabama at Birmingham, The Ohio State University Wexner Medical Center, WellStar Kennestone Hospital, University Hospitals Cleveland Medical Center, Case Western Reserve University, Augusta University, Rutgers, The State University of New Jersey, Tribhuvan University, Maharajgunj Medical Campus, Institute of Medicine, The University of Texas Southwestern Medical Center, Mayo Clinic
Language: English
Subfield: Education
Field: Social Sciences
Domain: Social Sciences
Open Access status: hybrid
Estimated APC paid: $3,420
OpenAlex ID: W7203481933