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Understanding the Ranking and Matching Behaviors During the 2023 and 2024 General Surgery Match Cycles: A Program Signaling Approach

Journal: Journal of Surgical Education Date: 2025/09, 82(9):Pages: 103599. doi: Subito , type of study: retrospective study

Full text    (https://www.sciencedirect.com/science/article/pii/S1931720425001801)

Keywords:

matching [17]
osteopathic medicine [2064]
ranking [1]
residency [334]
retrospective study [329]
signaling [2]
surgical care [63]
USA [1717]

Abstract:

Objective: General Surgery (GS) employed a static signaling practice with five signals per applicant in the 2022 to 2024 application cycles. Previous research demonstrated that signaling enhances a GS applicant's likelihood of being granted a residency interview. To understand the relationship between program signaling and ranking and matching outcomes in GS. Design: The analysis from the 2023 and 2024 Match data examined the relationship between signaling and three primary outcomes—inclusion on a program's rank order list (ROL), inclusion on the competitive portion of program ROLs, and matching. A multilevel model was utilized to explore how different factors impact an applicant's odds of being included on a program's ROL. Setting: This study is a collaboration between the NRMP, AAMC and NBME. Participants: Participants are medical residents who participated in the 2023 (N = 3903) and 2024 (N = 5057) Match cycles. Results: Signaling increases the odds of being ranked, and applicants who signaled had higher percentages of being ranked competitively and matching; however, the majority of those on the ROL and who matched did not send a signal. The odds of being ranked increase when the applicant signals a program (OR = 5.63, 95% CI [5.31, 5.98]), is from the same state as the program (OR = 3.52, 95% CI [3.35, 3.70]) or has a Step 1 score one standard deviation above the mean (OR = 1.77, 95% CI [1.74, 1.81]). The odds of being ranked are lower for programs with a high signal-to-application ratio (OR = 0.76, 95% CI [0.71, 0.80]) and for Doctor of Osteopathic Medicine (DO) (OR = 0.50, 95% CI [0.48, 0.53]) or international medical graduates compared (US IMGs: OR = 0.11, 95% CI [0.10, 0.13]; Non-US IMGs: OR = 0.11, 95% CI [0.09, 0.12]) to U.S. MDs, though all applicants benefit from the use of signals. Conclusions: Although signaling is not a requirement to be ranked, ranked competitively, or matched to a program in GS, those who signaled were ranked and matched at a higher percentage, with signals having the strongest effect on ROL inclusion.


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