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  1. What is preference signaling?
    Preference signaling is a process by which applicants are able to formally indicate specific interest to a program. Because each applicant only gets a certain number of preference signals, sometimes called “tokens”, the preference signal has some credibility and weight to programs.

    Preference signaling can be useful when there are many applicants for a given position, and it is difficult to differentiate between candidates. The preference signal provides an additional data point about a given applicant’s interest in a particular program.

  2. How does it work?
    An applicant will get a given number of preference signals, and can ‘send’ a preference signal to programs in which they have a particular interest. This occurs during the application process. An applicant can only send one preference signal to a given program; an applicant cannot, for example, send all preference signals to the same program.

  3. How many signals will I get?
    This year, each applicant will get five preference signals. While this may change in the future, in any given year each applicant will get the same number of preference signals.

  4. Do I have to use all of my signals?
    No. An applicant can use none, some, or all of the allotted preference signals. There is no requirement that all the preference signals are used.

  5. Should I sent signals to my home program or programs that I completed an away rotation at?
    No, you do not need to send a signal to your home program or any program that you are completing an away rotation at. The reason that you don’t have to use signals at your home program is because signals are a tool that do one thing alone: they increase your chances for an interview at a program for which your application is borderline.

    Thus, signals are part of game theory. To use a signal at a program where you have either a very high likelihood of an interview or a very low likelihood of an interview is a waste of the signal. Because you have a high likelihood of an interview at your home institution or a place you rotated (and some programs invite all rotators as a courtesy) the issue is the candidate is wasting it. So to spare applicants wasting a signal before they learn the game theory, we don’t advise it.

  6. Has this been done before?
    Yes. Preference signaling has been studied in the economic literature, and has been used in the business world. It was recently introduced into the residency application process. ENT trialed using tokens in 2020-2021 (Pletcher, Steven D. MD1; Chang, C.W. David MD2; Thorne, Marc C. MD, MPH3; Malekzadeh, Sonya MD4 The Otolaryngology Residency Program Preference Signaling Experience, Academic Medicine: May 2022 - Volume 97 - Issue 5 - p 664-668). They found that almost all programs received at least one preference signal, and program directors used it as a data point to break a tie between applicants. The end result is that applicants were more likely to receive an interview to which they had signaled preference. In this cycle, other specialties are using it including ENT, orthopedic surgery, urology, neurosurgery, dermatology, EM, and OBGYN.

  7. Will using a signal increase my chances of obtaining an interview at a program?
    There is some evidence that use of a preference signal increased an applicant’s chances of obtaining an interview at a signaled program. Using a preference signal is not a guarantee of an interview offer, but will be considered as a data point by programs.

  8. Will using a signal increase my chances of obtaining a residency spot in a program?
    No. The literature suggests that the preference signal gives an advantage to applicants in being invited for an interview.

    Rank lists for both programs and applicants should be based on a thorough evaluation and is most effective when rank lists reflect actual match preference.

  9. Must I send a preference signal to be considered at a program?
    No. Use of a preference signal is neither necessary nor sufficient to be considered at a program. Programs may offer interviews to applicants who have not sent a preference signal, and may not offer interviews to applicants who have sent a preference signal. The preference signal is a data point that indicates interest in a particular program.

  10. Is signaling confidential?
    Yes. Preference signaling is as confidential as any other part of the application. Just as programs cannot ask applicants where they have applied, programs may not ask applicants where they have signaled, and may not disclose who has preference signaled their programs or the number of signals the program received.

  11. Can I use my preference signals for programs that are not participating in the PSCA?
    No. Programs that are using ERAS only will not be part of the preference signaling component of the PSCA. Applicants will only be able to use the preference signals within the PSCA system.

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