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Are Signals Important to Match Into Anesthesiology?

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by Yousmle Staff in Residency

Are you applying to residencies and worried about anesthesiology program signals? How do anesthesiology residencies use signals? Do you really need to signal programs in anesthesiology? Will not signaling affect your anesthesiology residency application?

Look below to find the most important data from the most recent ERAS Program Director survey to learn more!

Table of Contents

What is Preference Signaling?

First, let’s describe more about preference signaling and why it’s used. Our guide to preference signaling delves deeper into the specifics and intricacies of preference signaling. In the guide, we have evaluated preference signaling on several parameters. Here is a brief summary for you. Preference signaling serves as a tool for applicants to clearly express their interest in a specific number of residency programs. It also facilitates direct communication with the chosen programs.

By signaling their interest, applicants highlight their authentic preference for the particular program. This helps program directors know which applicants are genuinely interested and thus should get invited to interview. Preference Signaling can thus come to your rescue as well as highlight your application to the program director.

While signaling is still being trialed with a limited number of specialties and programs participating, more are expected to join in 2024.

How Many Signals Were Available in Anesthesiology?

Of the 13 programs participating in preference signaling in 2023, anesthesiology was on the lower end with 5 signals available. You can see how anesthesiology compares with other residencies below.

Anesthesiology # of Signals Available - 2023

Anesthesiology Applicants Had 5 Signals Available

Why do some residency programs have more signals than others? The answer isn’t clear, but the program with the most signals, orthopedic surgery, is historically known to require a large number of applications to increase chances of matching. Other specialties like anesthesiology, dermatology, and diagnostic radiology are seeing big increases in signals available in 2024, so the system is still a work in progress. Check out our Guide to Preference Signaling to see the full list of programs and signals available in 2024.

How Did Anesthesiology Programs Use Signals in 2023?

Signaling was a big change to the application process in 2023, but did signals change how PDs chose which applicants to interview?

How PDs decide who to interview and how they weigh different experiences, attributes, and academic metrics is largely a mystery and different in each program. Standing out can be difficult with so many applications, so can signals help you stand out?

In the 2022-2023 Supplemental ERAS Program Director Survey, Anesthesiology PDs were asked about the importance of signals at each stage of the application process. You can see how Anesthesiology PDs answered below along with the importance in each stage.

Anesthesiology: How important were program signals at each of the following stages of the application review process?Did Not Use
% (n)
% (n)
Not Important
% (n)
Somewhat Important
% (n)
% (n)
Very Important
% (n)
Important or Very Important
% (n)
As a screening tool, before a more thorough application review8% (5)92% (57)0% (0)12% (7)28% (16)60% (34)88% (50)
Sending interview invitations to every applicant who signaled my program39% (24)61% (38)37% (14)37% (14)18% (7)8% (3)26% (10)
Including in a composite filter to conduct holistic review8% (5)92% (56)5% (3)23% (13)38% (21)34% (19)71% (40)
As part of a holistic process to help decide who to interview5% (3)95% (58)3% (2)22% (13)31% (18)43% (25)74% (43)
As a tie breaker when deciding who to interview15% (9)85% (53)4% (2)25% (13)30% (16)42% (22)72% (38)
During the interview to learn more about why an applicant signaled my program37% (23)63% (39)28% (11)26% (10)31% (12)15% (6)46% (18)
Plan to use during ROL discussion42% (26)58% (36)25% (9)36% (13)19% (7)19% (7)39% (14)
Other62% (8)38% (5)40% (2)20% (1)40% (2)0% (0)40% (2)

Signal Importance as a Screening Tool in Anesthesiology

Before selection for interview invites begin, programs must first screen applications to decide who would (or would not) be a good candidate for holistic review. Anesthesiology was at the top of specialties surveyed with 88% of PDs founding signaling to be important or very important as a screening tool.

Anesthesiology Signal Importance as a Screening Tool - ERAS PD Survey 2023

Anesthesiology PDs Relied Heavily on Signals as a Screening Tool


Signal Importance as Part of Holistic Review in Anesthesiology

While screening is the first hurdle for most applications, holistic review is where your experiences and application as a whole can be properly evaluated. While all specialties considered signals important as a part of holistic review, 74% of anesthesiology PDs thought signals were important or very important, which is near the top of all specialties surveyed.

Signal Importance as Part of Holistic Review - ERAS PD Survey 2023

Anesthesiology PDs were reliant on signals for holistic review

Signal Importance as a Tie Breaker in Anesthesiology

When deciding between two equal applicants to interview, all specialties found signals to be important as a tie breaker. Anesthesiology ranks near the top of all residencies with 72% of PDs finding signals as important or very important as a tie breaker.

Signal Importance as a Tie Breaker - ERAS PD Survey 2023

Anesthesiology PDs thought signals were useful to decide between candidates

Do I Need to Signal Anesthesiology Programs to Get an Interview?

Most applicants will apply to more programs than there are signals available. Signals are meant to highlight an application and show interest in a program. So will this change how programs view applications without signals? Do residency applications without signals get treated differently?

The answer is, it depends.

Looking at how PDs viewed applications, a blank signal value may be interpreted negatively.  This is true for anesthesiology with 66% of PDs interpreting a blank signal as meaning the applicant was less interested in the program. There were only 3 specialties higher than anesthesiology: OBGYN, diagnostic and interventional radiology, and orthopedic surgery.

No Signal = Applicant Was Less Interested

Anesthesiology PDs often interpreted no signal as meaning the applicant was less interested

Is lower interest a bad thing? Not inherently, but as we saw before with tie breakers, it could make the difference between getting an interview or not.

PDs were also asked if signaled applicants were treated differently than no signal. We can assume this means that at some point in the application review process, signals were considered.

Anesthesiology was again on the higher end of all specialties with 97% of PDs treating no-signal applicants differently than those who signaled. Only two specialties ranked higher with both dermatology and orthopedic surgery responding at 100%. Specialties that responded on the lower end are generally viewed to be less competitive with pediatrics, physical med and rehab, and emergency medicine responding at 84% to 85%.

Anesthesiology No Signal = Program Treated Applicant Differently

Anesthesiology ranked on the higher end of treating no-signal applicants differently

You can see the all results for anesthesiology and all specialties in the table below.

All Specialties: PD interpretation of no signalApplicant was less interested in my programApplicant was willing to go anywhereApplicant was afraid or unwilling to provide a responseDid not draw any conclusionsTreated the same as applicants who signaled my programOther
Adult Neurology39%17%6%53%17%0%
Diagnostic Rad & Interventional Rad75%14%8%24%4%0%
Emergency Medicine29%13%3%62%15%5%
General Surgery37%11%5%56%8%5%
Internal Med - Categorical51%23%14%33%12%5%
Neurological Surgery33%27%13%47%13%0%
Obstetrics and Gynecology69%17%8%25%12%6%
Orthopedic Surgery75%8%10%18%0%5%
Physical Med and Rehab43%19%16%43%16%5%

What are the Advantages of Program Signaling?

Pros: Preference signaling acts as a bridge. It aids applicants and program directors alike in finding the right match. For applicants, it’s an avenue to express genuine interest leading to increased interview invitations. Program directors get a streamlined selection process. Signals help identify candidates aligned with their program’s values.

Cons: Blank signals carry a risk of getting misinterpreted. A program director may draw false assumptions about an applicant who leaves blank signals. There’s also the concern of unfair advantages, where applicants who strategically signal might gain an upper hand.

Balancing transparency with integrity is vital. Preference signaling is relatively new to medical residency applications. It has only recently evolved from a nascent stage. Striking balance is essential to ensure a fair and authentic selection process.

Anesthesiology Signaling Strategies

  • Use all the signals available to you for your specialty.
  • While it’s been advised to not signal your home program, check with the program director first to confirm this until programs are adapted to the system
  • Note that each applicant should take an individualized approach to sending signals.  Consider factors such as application strength, overall competitiveness, career goals, and personal circumstances relative to the program’s mission before you choose where to signal.
  • Discuss with mentors and faculty to work out the programs where to send signals.
  • Consider the geographic preference
  • Sending signals may or may not result in a higher number of interview invitations. There are no guarantees.


Signaling is just one of the changes being implemented to help level the playing field for future applicants. While signals may play a larger role, it isn’t likely to increase matching chances more than having a well-rounded application. This includes avoiding any failed Step tests and getting the highest Step 2 CK score possible.

If you are feeling overwhelmed, you aren’t alone. We offer free consultations for students to help identify what is them back and how best to break through to help match into their dream residency. If you need to talk, book a consultation today and receive free lectures and Anki cards from the Yousmle Library on the topics students struggle with most!

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Want FREE Cardiology Flashcards?

Cardiology is key for impressive USMLE scores. Master cardiology from a Harvard-trained anesthesiologist who scored USMLE 270 with these 130+ high-yield flash cards. You’ll be begging for cardio questions - even if vitals make you queasy.