The residency and fellowship match processes in vascular surgery have evolved significantly over the past decade, shaped by changes in application behavior and increasing application volume, even as the ratio of applicants to available training positions has remained relatively stable. As applicants submit more applications per cycle and programs review substantially larger pools, the process has become increasingly complex for both groups. These dynamics have driven a steady rise in applications per applicant, reflecting a system that incentivizes higher application volume to maximize the chances of success.
In this context, the Association of Program Directors in Vascular Surgery (APDVS) recently voted to pursue adoption of program signaling, representing an important step in addressing these evolving challenges.
This decision follows a structured review of available data, experience from other specialties and careful consideration of the unique characteristics of vascular surgery training pathways. Although signaling has been used in other specialties for several years, its adoption within vascular surgery reflects a focused effort to improve alignment between applicants and programs in an increasingly complex application environment.
A changing application landscape
Over time, the vascular surgery match has seen a steady rise in applications submitted per applicant and received per program. Over the past decade, the average number of applications per program has increased by approximately 60%, while applications per applicant have more than doubled in recent years.
Importantly, this growth has occurred alongside increases in training programs and available positions, such that the ratio of applicants to positions has remained relatively stable. Despite this, both applicants and programs are managing substantially higher application volumes.
For programs, this has created a growing burden on program directors and faculty. In an era emphasizing holistic review, coupled with fewer traditional objective metrics, the ability to meaningfully evaluate an expanding applicant pool has become increasingly challenging. As volume rises, the tension between thorough review and practical feasibility has become more pronounced.
Many surgical specialties, including otolaryngology, plastic surgery, thoracic surgery and general surgery, have incorporated signaling to address similar challenges. Among surgical training pathways, vascular surgery has remained the only specialty not to adopt signaling, positioning it as a clear outlier.
Both integrated vascular surgery residency and fellowship pathways remain highly competitive and as application volume increases, the challenges of identifying genuine interest and performing meaningful holistic review have become more pronounced. In this context, experience from other competitive specialties provides a useful framework for considering how signaling might function within vascular surgery.
Program signaling: Concept and rationale
Program signaling was introduced as a pilot within ERAS during the 2020–2021 application cycle as a mechanism for applicants to express genuine interest in a limited number of programs at the time of application. At its core, signaling is a tool to inform interview selection, providing programs with an additional data point to identify applicants who may have a particular interest in their training environment. It is not designed to replace comprehensive application review, but to complement it within initial screening.
The rationale is straightforward: in an environment characterized by application inflation and diminished traditional signals, applicants gain a structured way to communicate preference and programs gain an additional tool to identify applicants with potential interest.
Survey data across specialties suggest that signaling is well received. Approximately 70%–80% of applicants report favorable perceptions, while favorable perceptions among program directors are similar or slightly higher, often approaching 80%–85%.
How program signaling works
Program signaling occurs at the time of initial ERAS application submission, when applicants indicate interest in a limited number of programs based on information available prior to the interview process. These signals are visible during initial review and may help inform interview invitations alongside other elements of the application.
Signaling is intended to function at this early stage and is not designed to influence decisions beyond interview selection.
Lessons from other specialties
Experience across specialties suggests that the impact of signaling is closely tied to the number and structure of signals used. Lower signal volumes preserve the strength and clarity of each signal but may have limited influence on application behavior. Higher volumes distribute signals more broadly but may reduce clarity and introduce the potential for signals to be used as a cutoff for offering interviews.
Signal allocation therefore represents a balance between preserving meaning and achieving meaningful distribution. Based on experience across specialties, the APDVS elected to pursue a two-tier, moderate-volume signaling approach in vascular surgery, with the goal of maintaining signal clarity while allowing applicants to express different levels of interest.
A two-tier signaling approach
Under this model, applicants will be able to send a total of 15 signals: three “gold” signals indicating highest interest and 12 “silver” signals reflecting additional programs of strong interest.
This structure allows applicants to differentiate levels of preference while maintaining flexibility in how they express interest. For programs, it provides a more nuanced understanding of applicant intent than a single-tier system.
This model is designed to preserve the meaning of a signal while allowing broader distribution, without encouraging rigid screening behaviors. It reflects a focused effort to improve alignment at the interview selection stage while maintaining flexibility for both applicants and programs.
Implications for applicants and programs
For applicants, signaling provides a structured way to communicate interest in a subset of programs at the time of application. In a highly competitive environment, this allows applicants to differentiate levels of interest and may improve their chances of receiving interviews at programs in which they have the greatest interest.
For programs, signaling offers an additional tool during initial screening to help identify applicants who may have stronger interest. In the setting of increasing application volume, this can help prioritize review and support more focused interview selection, while remaining one component of a broader assessment.
Signaling does not address all challenges within the match process. Application volume, interview distribution and broader structural factors will continue to influence outcomes. Rather, it represents an initial step in adapting to these trends and will be part of an ongoing process of evaluation and refinement to determine how best to improve alignment within the vascular surgery match.
Implementation and future direction
With the decision to adopt signaling, the focus now shifts to implementation and evaluation. As signaling is introduced, ongoing assessment will be essential to understand its impact on application behavior, interview selection and match dynamics.
Programs will be included by default, with the option to opt out. As experience develops, adjustments to signal number, structure and guidance may be considered to ensure that signaling functions as intended.
More broadly, signaling represents a response to a changing application environment and an opportunity to improve alignment at a critical stage of the match process. Its ultimate role within vascular surgery will depend on how it is used, evaluated and refined over time and how effectively it improves alignment within the match process.
