Preference Signaling is Here
One of the biggest challenges for applying to Emergency Medicine residencies is conveying genuine interest. Just applying to a program is not sufficient as many students apply to programs they have no desire to train at. Over-application is a completely rational response to a system where it is difficult to assess personal competitiveness and where the consequences of not getting enough interviews can be not matching in your desired specialty. This still leaves programs attempting to sift the “serious” applicants out of the pool of those who apply. We use surrogate markers like geographic ties, applicant interests and experiences that align with program strengths, or recent experience with applicants from that school.
In response a common practice developed of applicants also sending an emailed “letter of interest” outside ERAS. This is more work for the students and disliked by many Program Directors, especially when the letter did not add anything not already in the application they just received. If Program Director’s assume that applicants send these letters to all of the programs they applied to, they have no meaning.
Enter the idea of “preference signaling” by applicants to programs. The applicant does not have to write an additional letter and the program knows this signal has value as each applicant is limited to 5. How this came to be is covered really well in the Council of Residency Directors in Emergency Medicine (CORD-EM) Preference/Program Signaling Supplemental Guide. What I want to discuss here is how to approach using your 5 precious signals.
The goal is to positively influence Program Directors at places you have genuine interest and who would not have offered you an interview if there was no signal. Right now we don’t know for sure how programs will respond to a signal, but we can make some educated assumptions. Based on surveys, discussion forums, and data from other specialties, it is likely that a signal will make most programs more likely to interview you. However, the big exception will be among programs who receive an overwhelming number of signals. They will either make a signal a requirement for them to consider an application or ignore the signals entirely. This choice will depend on their assumptions around how applicants will use the signals.
Let's Talk Strategy
So how should you strategize using your signals? Here are a few general “rules” that apply to most applicants:
Use your signals on program you are genuinely interested in
Don’t signal programs you are rotating at unless they explicitly tell you that you need to
Signals are best used on programs where you might get an interview, but are not definitely getting one
Don’t waste them on programs where the signal is unlikely to convince them to interview you
Don’t waste them on programs that are highly likely to interview you anyway
Use your signals on program you are genuinely interested in
This is in here twice because there is real potential to over-game this system - don’t lose sight of the goal is to go somewhere you want
Even following those rules you can still come up with very different strategies for how to use your signals. Your training and career goals, self-assessment of your competitiveness as an applicant (aided by an experienced advisor) and your risk tolerance should all factor into your personal strategy.
Here are some examples that are a little more concrete:
Maximum Value - For the applicant worried about their competitiveness for interviews. Use your signals on programs you are interested in BUT that you expect to NOT get a lot of signals (less popular locations, less well-known, newer, or other evidence of being a less competitive program). The less signals a program gets the greater value each signal has.
Shooting for the Stars - For the applicant who is above average on paper and in the eyes of an experienced EM advisor. Use your signals on programs that are likely to get lots of signals. You will get many other interviews regardless and it may be necessary to signal the more “popular” programs to have a chance at an interview.
Balanced - For most applicants who don’t want to overthink this. Use three signals on programs that you are genuinely interested in and that are realistic for you (nothing about the program is telling you that this should be a hard interview to get). Use one signal on a program you are really interested in but where you suspect you don’t have a realistic chance at an interview. Use one on an acceptable program you expect to not get a lot of signals.
There is no evidence on what a “winning” strategy is for using Preference Signaling this year. If you have other ideas on how to approach this, put them in the comments below and we can talk them out.
Most important take home: Use your signals, and use them at places you are interested in.
Adam Kellogg has not done a very good job keeping this site updated during the pandemic. That has been fixed now with most of the Advising “pages” updated for 2022.
