2025-26 Tiered Program Signals for IM Residency Programs

Internal Medicine Tiered Program Signals for UME-GME: 3 Gold and 12 Silver

The 2024-2025 application cycle showed positive trends with internal medicine’s adoption of additional residency program signals with a tiered structure: IM candidates applied to fewer programs, signals were distributed more broadly across residency programs, and applicants who sent signals improved their likelihood to interview in a residency program. Given these favorable outcomes and to continue our study and data gathering, internal medicine will continue with its 15 tiered program signals structure for the 2025–2026 recruitment cycle: 3 Gold and 12 Silver.

As AAIM and AAMC continue their discussions and collaborations on the transition to residency, the recommendations set forth apply to Categorical IM programs. Please reference the Preliminary IM Internship Programs section for signal information specific to those programs.

AAIM recommends that all IM residency programs clearly state on their website how they will utilize program signals when making interview decisions and modify their respective website by July 31, 2025. Program signals help applicants indicate their interest to interview at a residency program they perceive they would thrive at and that would best fit their interests. Residency programs may benefit from using program signals to enable holistic review of those applicants most interested in their programs when making interview decisions.

New for this season, all IM residency programs will automatically be opted-in to receive program signals. Individual programs may elect to opt-out of participating in program signaling by indicating their choice in the Program Management tab of the Program Directors WorkStation (PDWS) and should do so by August 20, 2025. It is worthwhile to note that though a residency program elects to utilize program signals as part of its holistic review, this does not guarantee an interview.

The AAIM Residency Application Process Work Group is a cross-council group of Alliance volunteers. The AAIM Board of Directors charged the work group with examining the UME–GME transition application process for the benefit of applicants and programs and develop recommendations to guide Internal Medicine applicants, advisors, and residency program faculty.

If you have any questions, please contact EducationAndResearch@im.org.

Preliminary IM Internship Programs

Given limited data, it is currently unclear how the 15-tiered program signals (3 Gold and 12 Silver) affect preliminary IM programs. Preliminary IM programs should clearly indicate on their program’s website how they intend to use program signals and specify whether this is different than how they intend to use categorical program signals. To note, applicants send signals at the institution level for a given field. An applicant who applies to both an IM categorical and an IM preliminary program at the same institution would utilize one signal for IM at that institution. It is currently not possible to send a signal to an IM categorical program at an institution and not send one to an IM preliminary program to which the applicant has applied at the same institution.

Disclaimer: AAIM and the AAIM Residency Application Process Work Group acknowledges that the process of signaling, the number and nature of signals, and its impact on applicants and programs are dynamic and warrant additional investigation and research.

2025-26 Updates at a Glance

IM residency programs will continue using 3 Gold and 12 Silver signals for the 2025-26 cycle.
All IM programs will be opt-in for the 2025-26 cycle.
Individual programs may opt out no later than Aug. 20, 2025.
Preliminary IM programs will indicate their use of program signals on their website.