Analyzing Impact of Otolaryngology Signaling on Match Trends Between 2020 to 2024

Monday, October 13, 2025

3:12 PM - 3:18 PM EDT

Location: 109-110

Disclosure(s):

Brian L. Kwan, BA:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: Otolaryngology (OTO) remains one of the most competitive surgical specialties, with limited residency positions. It introduced a limited 25 preference signaling per applicant in 2021, which allowed more information to be communicated between applicants and residency programs. This study aims to analyze how preference signaling affected application metrics.

Methods: This retrospective database study analyzed matched OTO applicants using data from the Texas Seeking Transparency in Application to Residency (STAR) program from 2021 to 2024.

Results: Over the survey years 2021-2024, there were 393 respondents, with a 26.77% response rate for all OTO positions. In 2021, the number of matched students using preference signaling has grown substantially within OTO, increasing from less than 25% in 2021 to 95.7% in the 2024 match cycle. Across 2021-2024, mean publications for non-signaling applicants were 6.31±3.74, compared to 5.30±3.78 for signaling applicants (p < 0.01). Additionally, there was a lower number of volunteer experiences for signaling (6.00±3.42) compared to non-signaling applicants (7.82±3.15, p< 0.001). The average step 2 scores were not significantly different between signaling and non-signaling applicants. Finally, the number of applications per applicant has steadily decreased between 2021 (75.93±31.79) and 2024 (48.16±23.55).

Conclusions: Candidates with fewer traditional application strengths, such as publications and volunteering experiences, were more likely to match into OTO when using preference signaling. Strategically signaling allows candidates to potentially improve their chances of securing an OTO residency position. The decreased number of applications may indicate a growing trust in preference signaling on both the part of programs and applicants.

Presenting Author(s)

Brian L. Kwan, BA

M.D. Candidate
California Northstate University College of Medicine
Daly City, California, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Co-Author(s)

Brian L. Kwan, BA

M.D. Candidate
California Northstate University College of Medicine
Daly City, California, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.
Layla Ali, B.A., MD Candidate

Medical Student
California Northstate University College of Medicine
Elk Grove, CA, United States

Disclosure information not submitted.
Samuel H. Salib, BS

Medical Student
California Northstate University College of Medicine
Elk Grove, CA, United States

Disclosure information not submitted.
AA

Adam Y. Ali, BA

Medical Student
California Northstate University College of Medicine
Elk Grove, CA, United States

Disclosure information not submitted.
Preyasi Kumar, BS

Medical Student
California Northstate University College of Medicine
Belmont, CA, United States

Disclosure information not submitted.
MW

Michael S. Wong, MD

Associate Dean of Academic and Career Advising
California Northstate University College of Medicine
Elk Grove, California, United States

Disclosure information not submitted.

Senior Author(s)

MW

Michael S. Wong, MD

Associate Dean of Academic and Career Advising
California Northstate University College of Medicine
Elk Grove, California, United States

Disclosure information not submitted.

Co-Author(s)

AM

Angela P. Mihalic, MD

Dean of Medical Students and Associate Dean for Student Affairs
UT Southwestern Medical School
Dallas, Texas, United States

Disclosure information not submitted.