Anyone who’s winning at dating apps knows you’ve gotta cast a wide net. Unfortunately this edict has not translated well to ERAS. Residency interviews going virtual removed one of the last barriers of applying to institutions that won’t be in your top 35: cost of travel. And since programs in Utah and Alabama are now offering spots to the same applicants—who all along were choosing programs in Massachusetts and Pennsylvania—”increased applications and interview offers paradoxically increase both the number of unfilled positions and unmatched applicants.” Ouch. This editorial details the new geographic preference feature in ERAS introduced in 2023. Unsurprisingly, NRMP data demonstrates the vast majority of preferences across 9 potential regions were in the 3 regions with the vast majority of residency positions, raising concerns that this will be used as yet another tool to game the system. Indeed, applicants did receive significantly more interviews from regions they signaled than ones they didn’t, and one-third of program directors factored this information into rank list decisions. Finally, if you’re going to use the geographic preference, you may as well go all-in and choose 3 regions as those signaling only 1-2 received the least interviews. | Mahoney, Adv Radiat Oncol 2025
