Factors Associated With Interview Offer Rates in Otolaryngology Residency Applications

OBJECTIVE: To evaluate the association of preference signaling on interview offer rates in otolaryngology residency applications, comparing applicant type (MD vs DO), geographic status (in-state vs out-of-state), and international status (US vs non-US IMGs) across US programs and regions. STUDY DESIGN: Cross-sectional analysis. SETTING: All US otolaryngology residency programs with interview data participating in the 2024 to 2025 match cycle. METHODS: Data were obtained from the AAMC Residency Explorer Tool. Programs reporting interview rates for both signaled and nonsignaled applicants were included. Mean rates (±SD) were compared using Welch's t-tests. Effect sizes were calculated with Cohen's d. Regional differences (Midwest, South, Northeast, West) were analyzed using one-way ANOVA. RESULTS: Of 133 programs, 82 (61.7%) reported complete data. Programs invited signaled applicants at markedly higher rates than nonsignaled applicants (41.8% vs 5.0%, P < .001). Programs demonstrated significantly higher interview offer rates for MD and in-state applicants than DO and out-of-state applicants, respectively, across all regions (all P < .01). Differences between US and non-US IMGs were smaller and less consistent. No significant regional differences were observed in the magnitude of these effects. CONCLUSION: Preference signaling and applicant background were strongly associated with interview offer rates in the 2024 to 2025 OHNS cycle, with programs demonstrating significantly higher interview offer rates for MD, in-state, and signaled applicants across all regions. These findings highlight disparities in interview selection observed in the 2024 to 2025 cycle and emphasize the continued influence of both signaling and applicant characteristics on residency competitiveness.