- Samir Desai MD & Rajani Katta MD
What if I Don’t Match? An Introduction to the 2023 SOAP (Supplemental Offer and Acceptance Program)
What is SOAP? How does the SOAP match work?
In 2012, the NRMP established the Match Week Supplemental Offer and Acceptance Program (SOAP). This program is for both unmatched applicants and unfilled residency programs.
During SOAP, applicants apply to residency programs through ERAS.
Programs interview applicants, usually by phone or virtually, and then create and submit their preference lists.
Through a series of rounds, positions are offered to applicants.
The SOAP takes place over the course of one week.
As you can imagine, things move very quickly during SOAP.
The SOAP replaced a process known as the Scramble, an incredibly chaotic experience for both applicants and programs. During the Scramble, there was a flurry of emails, faxes, and phone calls from applicants to programs. Applicants often had friends, family, advisors, and consultants advocate on their behalf, and the process was overwhelming for all those involved.
The creation of the SOAP brought order to the process, and established a set of rules to which both applicants and programs must adhere.
The AAMC offers a webinar with an overview of the 2023 SOAP. Although the webinar is at capacity, they will have a recording available after the webinar takes place (on March 7th), as well as in your AAMC Dashboard.
Per the AAMC:
A recording of the webinar will be available after the event on the AAMC Webinars and Online Courses page.
SOAP Match Statistics:
The following are notable findings from the 2022 SOAP:
There were 12,836 applicants (1,279 fewer than 2021)
64.8% of SOAP-eligible applicants were IMGs
2,262 unfilled positions in SOAP
40.7% of these unfilled positions were PGY-1 positions only (537 preliminary surgery, 140 preliminary medicine, 10 preliminary obstetrics and gynecology, 2 preliminary pediatrics, and 218 transitional year)
Specialties with large numbers of positions in SOAP: FM (468), IM (451 categorical), pediatrics (80 categorical)
There were 370 more SOAP positions offered in 2022 compared to 2021
At the end of SOAP, 93.3% of unfilled positions were filled. 151 positions remained unfilled.
US MD seniors filled 43.2% of positions, US DO seniors filled 24.2% of positions, and IMGs filled 22.4% of positions (IMGs filled 473 positions total)
EM had 217 positions available in 2022 compared to 7 positions in 2021
Who can participate in the SOAP residency match?
Allopathic, osteopathic, and international medical students and graduates may participate in SOAP, as long as eligibility requirements are met.
These requirements include registering for the NRMP Main Residency Match, and being eligible to start residency training on July 1 of that year.
Below we answer some common questions about SOAP participation:
I did not apply to any programs prior to SOAP. Can I still participate in SOAP?
Assuming that you are eligible to participate in the residency match, you need not have applied earlier to participate in the SOAP process.
However, you must register for the NRMP Match. The late registration deadline is in March.
I applied to one specialty prior to SOAP. Can I apply to other specialties?
Yes. You can apply to other specialties.
I did not submit a rank order list. Am I still eligible to participate in SOAP?
Yes. You need not have ranked any programs to participate.
How do I know if I am eligible to participate in the SOAP match?
You will receive communication informing you of your eligibility to participate.
If you’re a U.S. medical student, you will be eligible for SOAP if your medical school indicates that you are on schedule to graduate before residency training begins on July 1.
For international medical students and graduates, ECFMG is responsible for verifying eligibility.
How does the SOAP residency match work?
One Month Before Match Week
The SOAP moves incredibly quickly, and you need to be prepared. In fact, after being notified of an unsuccessful match on Monday of Match Week, applicants only have limited hours to create, complete, and submit their applications for SOAP.
That's why it's so important to prepare in advance.
To make the most of this very short period of time, application documents should be prepared well in advance for any applicant who is at risk of not matching (and for those applicants who know ahead of time that they’ll be participating in SOAP).
Are there new letters of recommendation that need to be obtained for your specialty of choice?
Do you need additional letters for back-up specialties?
Will you need to write a personal statement for another specialty?
Will you benefit from an updated transcript?
Can the MSPE be updated to reflect all that’s happened since it was prepared the past summer?
These are all important considerations that you need to think about well before Match Week.
Once you determine what needs to be done, take the appropriate steps to ensure that these documents are available to you for the SOAP.
The SOAP Match Timeline for match week
At 9 AM EST Monday of Match Week
On Monday of Match Week at 9 AM EST, program directors and applicants learn the outcomes of the match process. One of three outcomes is possible for applicants:
A Complete match
With a complete match, your work is complete. You are fully matched. Congratulations!
An incomplete or partial match
An incomplete or partial match indicates that you are missing some component of your required training.
If you’ve matched to an advanced position (starting at the PGY-2 level or higher), then you are lacking a preliminary PGY-1 position. For example, you may have matched into dermatology but failed to match into a transitional or prelim program.
If you’ve matched to a preliminary PGY-1 position, then you’re lacking an advanced position to enter following completion of your PGY-1 year. In other words, you successfully matched into a prelim internal medicine position, but failed to match into a dermatology position
Failure to match to an advanced or preliminary position does not negate your successful partial match. Per NRMP rules, you must attend the program to which you’ve matched, but you have to now secure a position for the training you lack.
If you are partially matched, your best course of action is to participate in SOAP. This will give you the best chance of securing a position in an unfilled program.
Although there are usually some positions left unfilled after SOAP is completed, don’t wait until after Match Week to begin your search.
Fully unmatched applicants have failed to match at either prelim programs or other programs.
Both partially matched and fully unmatched applicants may participate in SOAP. These applicants will gain access to the list of unfilled residency programs.
What should you do if you learn that you're fully unmatched?
If you’re a U.S. medical student, contact your Dean’s office as soon as you learn of your unmatched or partially matched status. Medical schools often have resources and personnel ready to help you with the SOAP process.
We have further recommendations for all applicants below to help you as you go through this process.
What should you NOT do if you learn that you failed to match?
Although you may be tempted to contact unfilled programs, DO NOT do so.
The NRMP prohibits applicants from initiating communication with programs. You can only communicate with a program after the program has initiated contact.
Another important point: your advocates are also not permitted to initiate contact until after a program has communicated with you.
At 10 AM EST Monday of Match Week
ERAS opens for SOAP applicants to begin preparing applications. No contact is allowed from applicants or their representatives to programs.
After accessing the unfilled programs list, you will use the remaining time to work on your application, and then submit it.
At 8 AM EST Tuesday of Match Week
Programs are not permitted to view applications until 8 AM EST.
Note that last year there was a limit on the number of programs to which you could apply (< 45).
Don’t be afraid to apply to programs which did not invite you for an interview when you applied earlier in the cycle. It’s possible that they’ll view the strength of your application differently during the SOAP process.
At 8 AM EST, programs may view applications, and contact applicants. From this point until the end of SOAP (on Thursday of Match Week), you must be readily available for interviews.
You never know when a program may initiate contact, and you must be ready to respond to these communications by email or phone.
Local programs may request an in-person interview.
If you’re scheduled for clinical work, inform your supervisors of your situation and ask to be excused from your responsibilities, if at all possible, for the next few days.
If you fail to take a phone call or respond to email in a timely manner, the program will simply move to the next applicant.
Use the time you have to become familiar with each program to which you’ve applied.
In the event that a program contacts you, your research will allow you to make a favorable impression.
Programs create a SOAP preference list for the applicants that they have interviewed. In contrast to the NRMP Match (where both programs and applicants create rank order lists), in the SOAP only programs create and submit preference lists.
On Wednesday of Match Week
Programs will continue to review applications and interview applicants.
On Thursday of Match Week
Offers to applicants are extended through SOAP rounds.
The four rounds take place on Thursday:
The first at 9 AM EST.
The second at 12 PM EST.
The third at 3 PM EST.
The fourth at 6 PM EST.
Each round lasts two hours.
If you receive an offer for an unfilled position, you have three choices - accept, reject, or let it expire.
At 9 AM EST Thursday of Match Week
SOAP Round 1 begins. Applicants can log into the ERAS system to view offers. Please note that it is possible to receive multiple offers.
Applicants who receive an offer have 2 hours to accept or reject the offer. If you receive an offer, we recommend that you take it, unless you have a compelling reason not to do so. You should not assume that a better offer is coming. Note that most positions are filled in the first round.
If you reject an offer or let it expire, you will not receive an offer again from the same program.
Once an offer is accepted, it becomes a binding agreement between you and the program.
If no offer is extended, you will be given a list of programs that remain unfilled.
SOAP Round 1 ends on Thursday at 11 AM EST. The list of unfilled programs is updated in the ERAS system.
At 12 PM EST Thursday of Match Week
SOAP Round 2 begins. The same process will start until the SOAP Round 2 concludes at 2 PM EST and the unfilled programs is updated in the ERAS system.
At 3 PM EST Thursday of Match Week
SOAP Round 3 begins. The same process will start until the SOAP Round 3 concludes at 5 PM EST and the unfilled programs is updated in the ERAS system.
At 6 PM EST Thursday of Match Week
SOAP Round 4 begins. The same process will start until the SOAP Round 4 concludes at 8 PM EST.
At 9 PM EST, SOAP concludes.
At that point, the unfilled programs list is updated, and unmatched applicants are free to contact these programs as they see fit. In other words, you may contact these programs directly.
The bottom line: If you feel that you are at risk for not matching, then it's important to learn about the SOAP match procedures now and to be prepared well in advance.
Although failing to match is an incredibly stressful experience, thinking about this possibility ahead of time will allow you to plan and be prepared in case it happens. Although the SOAP match begins on Monday of match week, your preparation should be taking place in the month before match week. Applicants who do so have the best chances of succeeding in the SOAP.
Dr. Samir Desai is a faculty member at the Baylor College of Medicine and the author of The Successful Match: Rules to Succeed in the Residency Match. He is the co-founder of MD2B Connect, the most trusted and highest-rated provider of hands-on clinical experiences for IMGs in the U.S.
Dr. Rajani Katta is the creator of The Residency Interview 101, the online course that helps applicants quickly and confidently prepare for their residency interviews. She is also the co-author of The Successful Match: Rules to Succeed in the Residency Match and served as Professor of Dermatology at the Baylor College of Medicine for over 17 years.