Abstract
OBJECTIVE: To assess applicant opinions regarding program signaling and to understand the effect of 25 signals on interview outcomes during the 2023-2024 otolaryngology residency cycle. METHODS: A 36-item anonymous online survey regarding signaling was sent to applicants who had applied to an otolaryngology residency program at a single institution. Participant demographics, performance in medical school, number of interviews received in relation to signals sent, and applicant perceptions regarding preference signaling were assessed. RESULTS: Eighty-one applicants participated with a response rate of 30%. Students applied to a median of 64 programs. Approximately 84.4% of interview offers came from programs which the participants signaled. Participants were 5.4 times more likely to get an interview from a program they signaled over programs they did not signal (F = 31.73, p < 0.001). The most common factors that influenced which programs were chosen by candidates were: location (94.9%), departmental reputation (80.8%), and experience on a sub-internship rotation (69.2%). Overall, 73.0% of participants found signaling helpful and 82.0% agreed that signaling should continue. CONCLUSION: Understanding the implications of a high-signaling application process in otolaryngology is crucial. Twenty-five signals led to 84% of interview offers coming from signaled programs and this was the most important variable associated with interview invitations. Location was the most prevalent factor when deciding where to signal. Signaling was well reviewed by most applicants. LEVEL OF EVIDENCE: NA Laryngoscope, 135:80-86, 2025.