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Ob/gyn applications remained steady in the inaugural year of the specialty's new residency application system, according to early data from the American College of Obstetricians and Gynecologists (ACOG).

The specialty received applications from 2,400 people, of whom nearly 2,000 were U.S. applicants, which was a slight drop in the number of international medical graduate applications but otherwise generally in line with past years.

"The field of obstetrics and gynecology has always been uniquely challenging and rewarding, and it's gratifying to see that despite the demands of the current environment in which we practice, tomorrow's physicians continue to feel the calling and are just as committed to joining our specialty," ACOG President Stella Dantas, MD, said in a announcing the data. "Though we face increasing legislative, administrative, financial, and sustainability challenges, we are driven by a purpose that unites us all, across the stages of our careers."

In 2023, ob/gyn professional societies announced the specialty would break from the Electronic Residency Application Service (ERAS) run by the Association of American Medical Colleges (AAMC), and switch to an independent residency system. At the start of 2024, the groups released details about the new system, called ResidencyCAS. Some of the changes included a cheaper pricing structure (AAMC also announced a change in its pricing structure for ERAS shortly after ob/gyn did) as well as an emphasis on reviewing applicants holistically.

Despite this being the first year of the new system, 100% of ob/gyn programs opted to use ResidencyCAS. Nearly all applicants used program signaling, and 96% of applicants used all 18 signals they were granted to notify programs of particular interest. U.S. medical graduates applied to an average of 59 programs (median 52), which represented a drop from recent applicant cycles that saw averages in the 60s and 70s.

"I'm surprised it hasn't dropped more," said Bryan Carmody, MD, who runs the popular medical education blog "The Sheriff of Sodium" and closely follows residency and Match data. "It's still a lot of applications when you consider that the yield of interview offers from unsignaled applications is very low." Carmody also told MedPage Today that, anecdotally, he's heard from other specialties that adopted program signaling in recent years that their numbers are down more significantly.

One of the other major drivers for an independent residency system was to reduce the number of program applications per applicant and thus the number of applications a program had to assess, saving programs and applicants time and money. In ResidencyCAS, the first 18 applications, which cover the allotted three gold and 15 silver signals, only cost $99. Then the cost jumps to $18 apiece for applications 19 through 30, and anything above 30 is $23 per application.

Including signals is another way ob/gyn and other specialty programs have sought to decrease the number of applications. Data from showed that program signals greatly improved an applicant's likelihood of getting an interview offer with an ob/gyn program: nearly 55% with a gold signal, about 35% with a silver token, and less than 5% with no signaling.

"It makes perfect sense," Carmody said. "You can't interview everybody. And do you really want to spend your time interviewing an applicant that's sort of already telling you that your program's 19th on their list at best?" He also suspects that a lot of students are getting outdated advice from mentors and deans that they should apply to a higher number of programs, which in the new world of program signaling isn't going to necessarily pay off.

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