The Relative Influence of Program Signaling, Geographic Preferences, and In-State Status in Determining Odds of Interview Invitation in Residency Selection

Background Program signaling and geographic preferences are intended to give residency applicants agency in selecting preferred training locations while allowing programs to identify interested applicants. However, how these variables compare to in-state status (applicant’s permanent addresses in the same state as a program to which they applied) when interview invitations are offered is unknown. Objective To identify the relative influence of program signaling, geographic preferences, and an applicant’s in-state status in determining the odds of receiving an interview invitation during residency recruitment. Methods Data from programs and applicants in 9 specialties (anesthesiology, adult neurology, dermatology, general surgery, internal medicine, neurological surgery, pediatrics, physical medicine and rehabilitation, and psychiatry) from the 2023 Supplemental Electronic Residency Application Service application (SuppApp) were included. Logistic regression was used to determine odds ratios for all predictor variables. Results were aggregated across programs within each specialty. Results Between 51% and 81% of programs that participated in SuppApp within each specialty met inclusion criteria. Applicants were 2.71 to 9.07 times more likely to receive interview invitations when they signaled a program. When an applicant indicated a geographic preference that aligned with a program’s location, or no geographic preference, the odds of receiving an interview were 1.83 to 2.75 and 1.19 to 2.16 times more likely, respectively. In-state applicants were 2.45 to 5.14 times more likely to receive an interview. Conclusions Use of a program signal, an aligned geographic preference, no geographic preference, and in-state status all individually increase the likelihood of an applicant receiving an interview invitation.