An In-Depth Guide to Residency Program Signaling
Learn how to signal residency programs and boost your chances of matching.
Program signaling is now an integral part of the residency application process.
What are program signals?
How signals work
How programs use signals
Deciding which programs to signal
Common signaling mistakes
Signaling isn’t everything
Frequently asked questions
One of the more recent additions to the residency application process is program signaling. It can feel daunting to decide where to signal, but it’s actually simple, low-risk, and high-reward.
Program signals are an opportunity for you to express a genuine interest in specific medical residency programs. You’re not committing to your number one choice, like with a letter of intent. You’re simply signaling that you are particularly interested in certain programs.
The process of signaling is pretty straightforward and can greatly improve your chances of getting an interview invite. This guide will discuss what program signals are, how they work, gold vs. silver signals, how to decide where to signal, and common mistakes to avoid.
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What are program signals?
Residency program signals are a free way to indicate your particular interest in a specific residency program. Admissions committees and program directors most often use these signals to influence who to invite for an interview—not so much the final admissions decision.
You can signal through the MyERAS platform. Each specialty has a unique limit on how many signals you can send, but most specialties allow you to assign at least 15 program signals.
There are three signaling classifications that specialties can fall into:
Single-tier: You have a set number of signals. All the signals carry equal weight.
Two-tier: You have a certain number of gold signals and a certain number of silver signals. Gold signals carry more weight, but you typically have fewer to assign than silver.
Not participating: In rare cases, a specialty may not allow any program signals. Most of these are niche subspecialties. In recent years, the Association of American Medical Colleges (AAMC) has consistently shown that signals are exclusively beneficial to both applicants and programs, so they encourage everyone to use them.
Signaling started in 2020 with ENT applicants and expanded to essentially all specialties by the 2022-2023 application cycle.
It began as a countermeasure to “application inflation,” in which many candidates were submitting to a huge number of programs to increase their odds without a real interest in a particular residency. Program directors struggled to find the best candidates for interviews amid applicants who were “shotgunning” applications almost at random.
You’re still allowed to send out a large amount of applications, but with the finite number of (free) program signals, the residency programs will now see who is really most interested in their program. You may still be invited for an interview if you did not signal a program.
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How signals work
Each specialty has a certain number of preference signals that you can assign to participating programs. We (and the AAMC) recommend you use your maximum allotment of program signals. They’re a benefit to you (and the programs), and they cost you nothing.
Make sure you assign program signals before submitting your application. You can’t assign signals to submitted applications.
Important: If you signal a program, all tracks there (preliminary, categorical, or advanced) will see the same signal. You cannot signal tracks individually.
Below, we’ll go over how different parts of the signaling process work, including tiered signals, how many signals you get, how programs view your signals, and whether you should send to home vs. away rotations.
Tiered signaling (Gold vs. Silver)
For some specialties, you must use two-tiered signaling. You will have a certain number of gold signals and a certain number of silver signals.
Gold signals indicate that you have the highest level of interest in a given program.
Silver signals indicate that you’re more interested than if you hadn’t signaled at all, but not as interested as assigning a gold signal.
The strategy here on where to send gold vs. silver signals is to simply be honest:
Where are you genuinely most interested in training? Use a gold signal.
Where are you interested, but not the most interested? Use a silver signal.
Where might you be indifferent about attending? Don’t use a signal.
Here are the residency specialties that will use tiered signaling in the 2027 season:
Anesthesiology—5 gold, 10 silver
Child Neurology—3 gold, 6 silver
Dermatology—3 gold, 25 silver
Diagnostic Radiology—6 gold, 9 silver
Internal Medicine—3 gold, 12 silver
Vascular Surgery—3 gold, 12 silver
Other specialties will only use single-tiered signaling.
Home vs away-rotation program
In most cases, the general rule still applies when considering home vs. away rotation program signaling: you should signal programs where you’re genuinely interested in going. And one factor in your genuine interest is your geographic preference.
However, some rotations (AKA clerkships) that you complete during medical school will automatically interview you since you completed a rotation there. Check with the program to determine whether an interview is automatic, so you don’t waste a signal there.
For home and away rotations, if an interview is not automatic, assign a signal to them to indicate your interest. You are more likely to have a connection with the program, more likely to have a strong interview, and therefore more likely to match into the program.
If you’re running low on signals, and you’re deciding on signaling either a home rotation or an away rotation, it may be slightly more beneficial to signal your away rotation since geographic distance could give the program director pause when considering you for an interview.
If you do choose to signal a geographically distant program, we recommend giving a brief explanation in your program-specific personal statement as to why you’re looking to move far away. Perhaps it’s because you have personal or professional ties to the area that aren’t obvious on your application. Perhaps you love the area and see yourself living there long-term.
And yes, you can write multiple personal statements and assign them to different programs within the Electronic Residency Application Service (ERAS).
How many signals do applicants receive?
Each specialty allows a different number of program signals to be assigned.
If you’re applying to multiple specialties, you may use the maximum allotted number of signals for each specialty. For example, if you’re applying to seven Thoracic Surgery programs and nine Pediatrics programs, you can use all four Thoracic Surgery signals and all five Pediatrics signals.
Here are the residency specialties that will use tiered signaling in the 2027 season:
Anesthesiology—5 gold, 10 silver
Child Neurology—3 gold, 6 silver
Dermatology—3 gold, 25 silver
Diagnostic Radiology—6 gold, 9 silver
Family Medicine—5 signals
General Surgery—15 signals
Internal Medicine—3 gold, 12 silver
Internal Medicine/Medical Genetics—3 signals
Internal Medicine/Pediatrics—5 signals
Internal Medicine/Psychiatry—2 signals
Interventional Radiology—8 signals
Neurodevelopmental Disabilities—2 signals
Neurological Surgery—25 signals
Neurology—8 signals
Orthopedic Surgery—30 signals
Otolaryngology—25 signals
Pathology—5 signals
Pediatric Medical Genetics—3 signals
Pediatrics—5 signals
Pediatrics/Psychiatry/Child and Adolescent Psychiatry—3 signals
Physical Medicine and Rehabilitation—20 signals
Plastic Surgery—20 signals
Psychiatry—10 signals
Public Health and General Preventive Medicine—3 signals
Radiation Oncology—4 signals
Thoracic Surgery—4 signals
Transitional Year—12 signals
Urology—30 signals
Vascular Surgery—3 gold, 12 silver
Who can see your signals?
Only programs that you signal will see your signals. That means other programs will not see how many signals you used, which other programs you signaled, and whether you signaled any program at all.
For standard one-tiered signaling, if you signaled a program, the residency program director will see the word “Yes” on your application.
For two-tiered signaling, if you assigned a program with a Gold signal, they will see the word “Gold” rather than the word “Yes.” If you assigned them a Silver signal, they will see “Silver.”
If you do not signal a program—whether you signaled other programs or no other programs—the program will receive no information as to your signaled preferences.
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How programs use signals
Residency programs use signals as one part of a holistic review process. In fact, program directors consistently rank signaling among the top 3 considerations in selecting whom to interview for medical residency, along with Step 2 scores and recommendation letters.
Although a signal cannot overcome a weak resume (low Step 2 scores, lack of extracurriculars, etc.), many programs have begun to interview almost exclusively candidates who have signaled their interest.
This selective process benefits the program—yes—but it should also benefit you because you’re more likely to be invited to interview at programs you’re interested in.
Ultimately, it is supposed to restrict applicants from “shotgun” blasting their application to a bunch of programs they don’t really care about. With the recent signaling process in place, everyone is incentivized to only apply to programs they actually care to attend.
Programs essentially never consider signaling after the interview process—partly because your preferences may have changed during the interview, and partly because the interview is a much more impactful factor in their candidate preference than a signal.
In recent years, a large majority of successful candidates matched with programs they signaled. For example, in the 2023-2024 orthopedic surgery Match, 90% of matched applicants matched at a program they had signaled, while 79% of all interview offers came from signaled programs.
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Deciding which programs to signal
It can be stressful to decide where to signal your preference—since it’s such an impactful decision. But we’ve got expert tips below to make your decision easier.
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Consider your competitiveness and fit
Don’t assign your limited signals to all “reach” schools where you have no chance of getting in due to your application’s strength. Consider your competitiveness as an applicant and your culture fit for the campus.
Maybe one or two reach schools are okay to signal—depending on how many signals you get, which varies by specialty—but you should focus on residency programs that you can actually get into based on metrics like average Step 2 score of matched candidates and the quality of your letters of recommendation.
If you have geographic ties, an interest in their mission or culture, or specific career goals that mesh with a particular program, we encourage you to signal such a program. Your passion and fit will be bolstered by your interview, boosting your chances of matching.
Use the AAMC’s Residency Explorer tool by logging in with your AAMC username and password. With this tool, you can view verified data on where you might be the best fit.
Research programs thoroughly
You can learn a lot about a residency program from its website, forums, your mentors, and by getting in touch with alumni or senior residents.
Research as much as you can ahead of time to figure out if this is the sort of place where you want to spend years of your life training to practice medicine in a given specialty.
Faculty at your medical school may have insight into specific programs. They may even have enough of a connection to offer a strong letter of recommendation.
If you are participating in the Couples Match—officially administered National Resident Matching Program (NRMP)—research which programs are friendlier to couples. Hint: larger programs with more slots to fill are easier for couples to match into.
Your strategy should be honesty
Strategically use your signals to indicate your genuine interest. Don’t feel like you need to game the system. If you send signals to residencies where you actually want to go and where you are a competitive candidate, your odds for matching are greatly increased.
Sending too many signals to “reach” programs can reduce your likelihood of matching at all. Signaling too many “safe” programs may reduce your likelihood of satisfaction while increasing chances of burnout or dropping out.
Avoid sending signals to residencies that you care about for superficial reasons like the prestige—your misaligned interest may come out in the interview.
Although we recommend sending all allotted signals, don’t just send them to say you did. Take the time to determine where you will best fit the culture, the curriculum, and the mission.
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Common signaling mistakes
Avoid these common mistakes concerning residency program preference signals:
Don’t use your signals exclusively on “reach” programs that you aren’t a good fit for. Signals aren’t magic. They don’t counteract low USMLE scores or lackluster letters of recommendation. If you have at least 10 signals allotted, you may use one signal on a slight reach program, but do not waste your signals on residencies where you aren’t a good fit.
Don’t ignore if a program has chosen not to participate in signaling. Some individual programs choose not to participate in residency signaling. Make sure you read over the program’s unique application guidelines before you waste a signal, or worse, you demonstrate that you don’t know how to follow directions.
Don’t forget to familiarize yourself with your specialty’s specific signaling guidelines, especially the limited allotment of signals, which varies by specialty.
Don’t assume a signal guarantees an interview. It does increase your likelihood, but you still need a standout ERAS application and to apply to programs where you’re a good fit. If you have a bad mark on your application, make sure to explain it on your application and demonstrate your growth since then.
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Signaling isn’t everything
Program signals are not the be-all end-all. You can technically match into a program without signaling. However, it is becoming increasingly rare for applicants to match into a residency program where they did not signal.
Signals are also not the only way to indicate your interest. After you’ve interviewed, you can send a letter of interest to slightly boost your odds of matching—although it may not be worth your time. A letter of intent is much more likely to increase your odds.
If you have one residency that you really want to go to—and you know you will rank them first on your rank order list (ROL)—you can send that one program a letter of intent. This letter demonstrates that you would choose this program above all others, so you can only send one.
Also, networking can be very effective in signaling your interest. Before the interview, you can network with alumni and current residents—probably improving your interview performance since you have more information. After the interview, networking can move the needle for similarly qualified candidates. If someone on the committee has heard about you connecting with alumni or residents, it may help in a tiebreaker scenario.
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Frequently asked questions
Can I change my residency signals after submitting my application?
You cannot unassign signals or change signals after you’ve submitted your residency application.
However, if you have unused signals, you can still assign them to applications that have not yet been submitted or received.
What happens if I don't use all of my signals?
If you don’t use all your signals, nothing really happens. You’re not directly penalized, but there’s no benefit. However, you are indirectly penalized if you don’t use all program signals since almost all successful applicants (perhaps as high as 98%) match into programs where they assigned a signal.
Use all your program signals. They come at no cost to you, and they should really only benefit you and the application process.
Does signaling increase my chances of getting an interview?
Yes, signaling increases your odds of getting an interview offer. The primary purpose of program signals is to indicate your interest in a given program. The primary way program directors use signals is as a screening tool to determine who to invite to interview at the program.
The vast majority of residency applicants who successfully match into a program are matched to the program to which they assigned a program signal. Although program signals are beneficial to the interview invite process, not the final admission process, getting an interview is a huge step toward being admitted.
Should I signal my dream programs or safer programs?
If you are not a good fit for your dream program—due to low Step 2 scores, weak recommendation letters, lackluster extracurriculars—then you should only use one program signal on such a “reach” school, as long as you’re in a specialty with more than five signals allotted.
If you have more than 10 signals allotted to you, feel free to use one of these signals to indicate your interest in a reach program. But don’t waste a signal when you have no chance of getting in.
We also recommend not wasting signals on “safe” programs that you’re overqualified for.
Ultimately, you should determine which residency programs you are a good fit for based on USMLE scores, shelf exams, clinical hours, letters of recommendation, and other key factors.
Final thoughts
Residency program signals are a relatively recent addition to the ERAS process. It has quickly become a top consideration for program directors when they’re deciding who to invite for interviews. It should also benefit you by increasing your likelihood of being matched with a program you genuinely care about.
If you need more personalized guidance, we’re here for you. Our expert advisors have helped applicants like you match into the residency of their dreams.
About the Author
Dr. Shirag Shemmassian is the Founder of Shemmassian Academic Consulting and one of the world's foremost experts on medical school admissions. For over 20 years, he and his team have helped thousands of students get into medical school using his exclusive approach.
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