SKIN July 2022 Volume 6 Issue 4 (c) 2022 THE AUTHORS. Published by the National Society for Cutaneous Medicine. 343 SHORT COMMUNICATION Preference Signaling in the Dermatology Residency Match McKenzie A. Dirr, BA, BS1, Nicholas Brownstone, MD2, Darrell Rigel, MD, MS3 1 Medical University of South Carolina, Charleston, SC 2 National Society for Cutaneous Medicine, New York, NY 3 Department of Dermatology, Mount Sinai Icahn School of Medicine, New York, NY The residency match, facilitated by the National Resident Matching Program (NRMP) organization, which utilizes the Association of American Medical Colleges (AAMC) Electronic Residency Application Service (ERAS), facilitates the determination of where senior medical students will continue their education as resident physicians.1 Created in 1952, the match is the culmination of a reciprocal interest between students and residency programs, whereby both entities rank prospects in order of interest. 1 As certain specialties have become inundated with interested applicants, alternative or adjunct methods for increasing match success have been implemented. 1 In the 2020-2021 cycle, Otolaryngology initiated preference signaling (PS), in which students send a signal to a set number of residency programs to indicate a high level of interest in matching to that particular program.2,3 The purpose of initiating PS into medical residency match is to clarify a student’s intentions prior to the release of interview invitations. 2,3 Participation in PS is optional, and students who choose to participate in PS are still encouraged to submit as many applications as they wish, while only schools receiving a signal are notified of the student’s action. 4 This notion has similarly been adopted by other specialties, including general surgery, internal medicine, and dermatology as part of the supplemental ERAS application.4 In August of 2021, the Association of Professors of Dermatology announced participation in preference signaling in the 2021-2022 application cycle.5 Within dermatology, each student is allotted three preference signals to distribute to various schools, which are not ranked in any particular order of interest.4 Importantly, students are directed to not send a PS to programs at which they have done in-person rotations, including their home institution. 4 In an assessment of the 2022 supplemental application, the AAMC published key findings which give insight into the state of residency application.6 Within dermatology, 117 out of 135 U.S. programs and 93% of applicants chose to participate in the supplemental application.6 Applicants chose to send signals based on various reasons, the most important factors being geographic location, quality of training, and program correspondence with career goals.6 It is important to evaluate the success of PS within each specialty, including dermatology, as well as areas for future improvement. As reported by the AAMC key findings, one- fourth of dermatology programs received up to 53% of preference signals from all applicants, indicating a skewed distribution of signals across programs.6 This may be due to SKIN July 2022 Volume 6 Issue 4 (c) 2022 THE AUTHORS. Published by the National Society for Cutaneous Medicine. 344 individual program factors, with more competitive residencies receiving more signals as a prerequisite for applicant consideration, or applicants sending signals to programs in which they are somewhat interested to increase chances of consideration.2 However, it is clear that PS played a major role in interview determination, with programs reporting PS usefulness in identifying unlikely candidates and determination of interview invitations.6 More studies are needed to determine the role preference signaling plays in the dermatology match itself, and in particular, the impact on final resident class determination. Conflict of Interest Disclosures: None Funding: None Corresponding Author: McKenzie A. Dirr, BA, BS Medical University of South Carolina 96 Jonathan Lucas Street Suite 601, MSC 617 Charleston, SC 29425 Phone: 843-792-2081 Email: dirr@musc.edu References: 1. Mott NM, Carmody JB, Marzano DA, Hammoud MM. What’s in a Number? Breaking Down the Residency Match Rate. The New England journal of medicine. 2022;386(17):1583-1586. doi:10.1056/NEJMp2119716 2. Gangal A, Blalock TW. A perfect match: Pros and cons of preference signaling in dermatology. Journal of the American Academy of Dermatology. 2021;84(5):1504-1505. doi:10.1016/j.jaad.2020.12.050 3. Chang CWD, Pletcher SD, Thorne MC, Malekzadeh S. Preference Signaling for the Otolaryngology Interview Market. The Laryngoscope. 2021;131(3):E744-E745. doi:10.1002/lary.29151 4. Association of American Medical Colleges. Supplemental ERAS Application Guide. https://students- residents.aamc.org/media/12326/download. Published August 2021. Accessed May 2022. 5. Association of Professors of Dermatology. Dermatology APD Statement on 2021-2022 Application Cycle. https://students- residents.aamc.org/media/12386/download. Published August 20, 2021. Accessed May 2022. 6. Association of American Medical Colleges. AAMC Supplemental ERAS® Application: Key Findings From the 2022 Application Cycle. https://www.aamc.org/media/58891/download. Published February 2022. Accessed May 2022. mailto:dirr@musc.edu https://students-residents.aamc.org/media/12326/download https://students-residents.aamc.org/media/12326/download https://students-residents.aamc.org/media/12386/download https://students-residents.aamc.org/media/12386/download https://www.aamc.org/media/58891/download