To the Editor In their Viewpoint, Salehi et al1 proposed a “star system” in which otolaryngology residency applicants can indicate particular interest in programs, similar to a “rose-sending system” previously suggested in orthopedic surgery.2 In the economics literature, these systems are known as preference signaling mechanisms and have been successfully implemented in the American Economic Association (AEA) job market for economics graduate students since 2006. Its rationale, design, and outcomes should inform the current proposal.3
Chen JX, Deng F, Gray ST. Preference Signaling in the National Resident Matching Program. JAMA Otolaryngol Head Neck Surg. 2018;144(10):951. doi:10.1001/jamaoto.2018.1558
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