How concentrated signals are, by specialty
The AAMC's signal reports include a concentration measure: of all the signals received in a specialty, what share went to the 10% of programs that received the most. The 2027 residency snapshot, as of October 1, 2026, gives a wide range.
- Internal Medicine (3 gold)34%
- Family Medicine (5)33%
- Child Neurology (3 gold)30%
- Internal Medicine/Pediatrics (5)29%
- Radiation Oncology (4)28%
- Psychiatry (10)27%
- Radiology-Diagnostic (6 gold)26%
- Pediatrics (5)25%
- Surgery (15)24%
- Anesthesiology (5 gold)23%
- Neurology (8)23%
- Transitional Year (12)23%
- Pathology (5)21%
- Dermatology (3 gold)21%
- Urology (30)17%
- Orthopaedic Surgery (30)16%
- Neurological Surgery (25)16%
- Plastic Surgery-Integrated (20)15%
| Specialty | Signals per applicant | Programs | Top 10% of programs | Share of signals |
|---|---|---|---|---|
| Internal Medicine | 3 gold | 689 | 69 of 689 | 34% |
| Family Medicine | 5 | 789 | 79 of 789 | 33% |
| Child Neurology | 3 gold | 83 | 8 of 83 | 30% |
| Internal Medicine/Pediatrics | 5 | 77 | 8 of 77 | 29% |
| Radiation Oncology | 4 | 80 | 8 of 80 | 28% |
| Psychiatry | 10 | 348 | 35 of 348 | 27% |
| Radiology-Diagnostic | 6 gold | 188 | 19 of 188 | 26% |
| Pediatrics | 5 | 210 | 21 of 210 | 25% |
| Surgery | 15 | 354 | 35 of 354 | 24% |
| Anesthesiology | 5 gold | 188 | 19 of 188 | 23% |
| Neurology | 8 | 199 | 20 of 199 | 23% |
| Transitional Year | 12 | 188 | 19 of 188 | 23% |
| Pathology | 5 | 133 | 13 of 133 | 21% |
| Dermatology | 3 gold | 141 | 14 of 141 | 21% |
| Urology | 30 | 150 | 15 of 150 | 17% |
| Orthopaedic Surgery | 30 | 207 | 21 of 207 | 16% |
| Neurological Surgery | 25 | 122 | 12 of 122 | 16% |
| Plastic Surgery-Integrated | 20 | 93 | 9 of 93 | 15% |
What the average program receives
Percentages can understate how many signals a program gets. In the snapshot, the average internal medicine program received 106.5 gold signals and the maximum was 913. Family medicine programs averaged 65.6 signals, with a maximum of 587. Orthopaedic surgery programs averaged 256.6 signals each and transitional year programs 357.7, because those specialties give each applicant 30 and 12 signals. One transitional year program received 1,302.
An internal medicine program with around 100 gold signals has plenty of interested applicants to pick from. That fits the interview data, where applicants who did not signal had medians near zero in many specialties. For the program, the pile of signals is the pool it interviews from.
Why concentration differs
A simple explanation fits much of the table: when applicants have few signals and many programs to choose from, they end up on the same shortlist. Internal medicine gives 3 gold signals across 689 programs, and family medicine gives 5 across 789. In orthopaedic surgery an applicant has 30 signals for 207 programs, enough to cover a good part of the field, and concentration drops to 16%.
It is not a clean rule. Dermatology also gives only 3 gold signals and sits at 21%, and psychiatry (10 signals) is more concentrated than pediatrics (5). This data cannot tell us what else is at work.
Within a specialty, gold concentrates more than silver. In internal medicine the top 10% of programs took 34% of gold and 27% of silver. In diagnostic radiology it was 26% of gold and 20% of silver. Applicants are careful with gold, but a lot of them are careful in the same direction.
What the data does not say
Three cautions. First, "top 10%" means the programs that received the most signals, not the highest-ranked or most prestigious ones. The two overlap but are not the same. Second, the data does not show that signaling a less-signaled program improves your odds. A program with few signals may be less competitive, or it may be less attractive for reasons you would want to know about. Third, this is a snapshot of a season in progress, and the shares will move before it closes.
Using it to place your signals
The useful takeaway is about fit. In a highly concentrated specialty, the programs on everyone's shortlist are getting a lot of signals, so a signal there is competing with many others. A program whose score expectations, graduation-year policy and IMG history match your profile is a more sensible place to spend one, whatever its signal count. The signal limits by specialty table shows how many you have to place, and our specialty pages list each program's IMG share, visa sponsorship and interview rate.
If you are an IMG, the same logic applies with more force. Read the IMG guide to program signals next. And for what signals have been associated with so far in interview rates, see Do residency program signals get you interviews?