A recent JACC review explores the growing impact of Electronic Residency Application Service (ERAS)-based signaling in cardiology fellowship recruitment, highlighting the most recent data, areas of future investigation, and practical guidance for applicants and programs.

Victor Soukoulis, MD, PhD, FACC, along with other members of ACC’s Program Directors and Graduate Medical Educators Member Section, note several important observations that emerged from the 2025 fellowship recruitment season – the first year of ERAS-based signaling:

1. Cardiology fellowship remains among the most competitive internal medicine specialties.
2. Signaling adoption was rapid and nearly universal among both applicants and programs.
3. Early data showed that the average number of applications submitted per applicant and the average number of applications received per program both slightly decreased.
4. Signaling appeared to meaningfully influence interview selection.
5. Signaling distribution was not uniform.

The authors emphasize that implementing signaling may help reduce application burden, time and financial costs for applicants. Notably, it is not yet clear if signaling helps programs offer interviews to better-suited candidates, nor if applicants have better match outcomes.

Moving forward, Soukoulis and colleagues believe programs should continue contributing signaling data and be transparent with applicants regarding the review process. “Future analyses should examine trends in the number of applications submitted and signal-to-interview conversion rates, ideally incorporating match outcome data from the [National Resident Matching Program],” they conclude.