Signaling the Signaler: How Do Radiology Residencies Plan to Use Gold and Silver Signals to Evaluate Applicants?

Purpose: In the 2023-24 diagnostic (DR) and interventional radiology (IR) residency application, the Electronic Residency Application Service® allowed applicants to send 6 gold and 6 silver signals to residencies. However, the impact of these factors on interview offers and applicant ranking remains unclear. This study was done to survey DR and IR residencies on how these signals will be used to evaluate applicants.

Methods/Materials: An anonymous, cross-sectional study of DR and IR residency program directors, assistant program directors, and program coordinators was conducted. SurveyMonkey® was used to collect data regarding how signals would be used when determining whether to interview and rank applicants. A z-test of proportions was utilized to evaluate a difference between proportions with a significance level of 0.05.

Results: 70 participants included 55 (78.6%) from DR and 15 (21.4%) from IR residencies. There were 41 (66.1%) university-based programs, 17 (27.4%) university-affiliated programs, and 4 (6.5%) community-based residencies. The majority recommended applicants to submit a signal to their home institution’s program (n = 39, 63.9%) and programs where they completed an away rotation (n = 41, 68.3%).
The vast majority of respondents reported gold signals (n = 57, 91.3%) would likely be used to extend an interview. This was significantly different from how silver signals (n = 49, 79.0%) would likely be used (z = 2.04, p = 0.041). Fewer indicated gold signals would be incorporated in the decision to rank an applicant compared to silver signals (26 vs. 23; 41.9% vs. 37.1%; z = 0.55; p = 0.582), and this was similar to whether signals would be used for ranking an applicant higher (20 vs. 18; 32.3% vs. 29.0%; z = 0.39; p = 0.697).

Conclusions: Of participating residency programs, most recommended applicants signal their home programs and residencies at which they completed away rotations. The majority reported that gold and silver signals would influence their decision to offer an interview. Both types of signals are also likely to be used by 30-40% in the ranking process.