Alignment Insights

What should I use my Alignment insights for?

Use your report to:

• Focus your program search
• Help you decide where to apply
• Plan your program signaling strategy

Alignment Insights is a guidance tool, not a guarantee. To make informed decisions, combine it with other resources such as program websites and advice from your advisors or mentors.

How and When to Request a Report

Before you request your Alignment Insights report, keep in mind:

• The best time to request a report is after you’ve completed most of your application. Think of your report as a snapshot in time – the more complete your application is before requesting, the more accurate it will be.
• You’ll receive your Alignment Insights report only once. 
• Once your report is ready, which may take up to 24 hours, you’ll receive an email and a secure notification in the ResidencyCAS application with an encrypted link to your personalized report.
• Reports are available through September 17 and will not be accessible after that date.

You can request a report starting August 24, 2026. An Alignment Insights section in the ResidencyCAS application (visible only to OB-GYN applicants) will let you review a brief disclosure, see how the process works, and grant permission to use your application data.

Opting In to the Alignment Check Index (ACI)

When you request your Alignment Insights report, you will be asked to complete the optional ACI survey. This enables you to receive an ACI score for programs that signifies how closely you match their self-reported ACI values. This should be used in combination with your Historical Alignment Scores when deciding where to apply and signal.

Completing Your Application Before Requesting a Report 

While not all sections are required, the following must be completed before your report can be generated:

• USMLE/COMLEX scores
• Applicant type (MD, DO, or IMG)
• Current/permanent postal code (not required for IMGs)

The following items are recommended to improve the accuracy of your report, but are not required: 

💡 Tip: the more complete your application, the more accurate your report. If your application meets the minimum requirements but could be stronger (e.g., you listed some experiences but not all), this will be reflected in your report. Keep in mind that reports aren’t updated if you add information later. 

Common Questions about Requesting a Report and Application Completion

What if I receive a very high number of programs with Low Alignment?

Mostly Low Alignment ratings don’t mean you won’t get interviews or match – they simply show your application is less similar to past interviewees at those programs. You can still apply to any program you choose.

💡 Tip: use Low Alignment results as a signal to focus on programs where you may have other strengths, such as mission fit, location, or unique opportunities. The Alignment Check Index, program websites, and your advisors can help you find programs that may align better with your goals.

Do high ratings guarantee an interview?

No, Alignment Insights is for guidance only – it doesn’t guarantee or influence interview decisions. Programs don’t see your rating or know if you've requested a report. Residency selection is highly competitive, so even a high rating doesn’t ensure an interview offer. Use it as one factor in your planning, not a prediction of the outcome.

How should I interpret the Alignment Insights Factors Explanations?

Three Factor Explanations are visible for each program. These show the key factors that influenced your alignment rating for that program. They help you understand why a program appears as Very High, Medium, Low or Very Low Alignment. Remember, they’re based on past applicant trends and don’t predict or guarantee future interview decisions.

What should I do when the Historical Alignment disagrees with the Alignment Check Index? 

When the two scores agree, interpretation is straightforward: a program showing both a High Historical Alignment Score and a strong Alignment Check Index (ACI) rating is one where your profile matches both past trends and stated future priorities, making it a strong candidate for your list. When the scores disagree, take a closer look before drawing conclusions. A High Historical Alignment Score paired with a weaker ACI may mean your profile fits the program's past patterns well, but your application does not closely match the qualities the program says it is now prioritizing — this is worth noting, but not necessarily a reason to deprioritize the program. Conversely, a strong ACI with a lower Historical Alignment Score may indicate that while your profile differs from past interviewees, you align well with where the program says it is headed. In either case, use the Factor Explanations, Program Level Preferences, and guidance from your advisor to weigh the full picture before deciding where to apply or signal. 

How do I use the Program Level Preferences?

Program Level Preferences are available within your Alignment Insights report and help you narrow the list of programs based on what matters most to you. You can set preferences across the following categories:

• Historical Alignment Score — Select by alignment rating: Very high, High, Medium, Low, or Very lowt
• Region — Select by U.S. geographic region: Northeast, Midwest, South, or West
• Geography — Select by community setting: Urban, Suburban, or Rural
• Program Type — Select by program structure: University-based, Community-based university affiliated, Community-based, or Other
• First Year Positions — Select by number of first-year positions: 1–4, 5–6, or 6+
• Visa Sponsorship — Select by visa type supported: J-1 visa sponsorship through ECFMG, H-1B visa, or F-1 visa (OPT, first year)
• Fellowships — Select to show only programs that do or do not offer fellowship opportunities
• Participating Programs — Select by number of participating institutions: 1–2, 3–4, 4–6, or 6+ 

Select one or more values within any category to adjust your results. Choosing multiple values within a single category broadens your list (for example, Urban and Suburban), while combining selections across categories narrows it (for example, High Alignment + Northeast + University-based shows only programs that meet all selected criteria). By default, all values are selected, so all programs appear until you make a selection. Within each displayed Historical Alignment rating, programs remain sorted by their relative alignment with past applicants who were invited to interview at that program. 

These preferences are especially useful when you have many strong matches. Start with location-based preferences like region or geography, then refine further with program type, size, or other priorities. If you require visa sponsorship, setting that preference early ensures you focus only on eligible programs. 

Does the Alignment Insights Report differ if I’m an IMG? What about DOs vs. MDs?

The tool works the same for all applicants. However, ratings and factor explanations may differ based on whether you’re an IMG, DO, or MD because they reflect historical data for applicants like you. All applicant types are included fairly in the analysis.

How should I use program signaling with Alignment Insights?

Program signals aren’t part of the Alignment Insights model. Use your ratings to guide your signaling strategy – start with Very High Aligned programs, then consider High Aligned programs that fit your interests or location. Remember, Alignment Insights is for guidance only – combine it with advisor input, the Alignment Check Index, and your personal goals.

💡 Tip: review your Alignment Insights first, then decide where to signal to target programs more effectively.

Why don’t some programs show an alignment rating?

Some programs won’t display a rating if:

• They didn’t provide interview data from the previous cycle, or
• They’re new and don’t yet have historical data.

These programs appear as Unscored in the report. You can still apply or signal them as usual – missing data doesn’t mean you’re less likely to be considered.

What if I have more questions or need help with Alignment Insights? 

For questions about Alignment Insights, contact transitionfeedback@apgo.org.

Additionally, for technical support, you can review our technical requirements or contact us for support.