Understanding SOAP Residency Match and Your Options

The SOAP (Supplemental Offer and Acceptance Program) residency match is a process that occurs during the main residency Match Week, organized by the National Resident Matching Program (NRMP) in the United States. It is a second chance, of sorts, that is designed to match unfilled residency positions with applicants who have not secured a residency spot through the main Match process. 

The SOAP process provides a structured system for applicants to apply to residency programs that have unfilled positions, and has had a lot of success for both the position and applicant.

How does SOAP Match Work?

To participate in SOAP, applicants must be registered for the Match and have applied to at least one residency program through the Electronic Residency Application Service (ERAS). Applicants who did not match to a residency position during the initial Match process become eligible for SOAP.

1. Obtain the list of Unfilled Residency Positions: After the main Match results are announced, the NRMP releases a list of unfilled residency positions available for SOAP.
2. Submit an Application: Eligible applicants can submit applications to these unfilled positions through ERAS. They have a limited amount of time (usually a few days during Match Week) to apply to programs.
3. Get Interviewed: Programs review applications and may contact applicants for brief interviews, usually by phone or video call.
4. Go through the Offer Rounds: SOAP operates through several rounds of offers. Programs extend offers to candidates through the NRMP’s R3 system, and applicants have a limited time to accept or decline offers. If an applicant declines an offer or does not respond within the specified timeframe, the offer expires, and the program may extend it to another candidate.
5. Finalize your Residency Placement: The SOAP process concludes at the end of Match Week. Applicants who have accepted offers through SOAP finalize their residency placements. Those who do not secure a position through SOAP may seek residency positions outside of the Match.

The SOAP residency match is a critical component of the Match process, ensuring that as many residency positions as possible are filled and that applicants have an additional opportunity to find a residency spot.

A First-Hand Account of Going through SOAP

My name is Megan and I was unmatched. I am now a PGY-3 general surgery resident. If you find yourself unmatched, breathe. 

Late in my fourth year, I decided the initial specialty I chose was not a good fit. I decided to withdraw that application and attempt to SOAP into general surgery. Unfortunately, I did not SOAP successfully. However, I was able to secure a preliminary general surgery position after SOAP (after several months) by applying to positions on ADPS Open Positions website.

SOAP is a stressful process, but many applicants find a position and are ultimately happy despite the circumstances. SOAP is a time to be realistic. If you have a red flag that cannot be fixed or improved upon, I suggest applying to an average competitive residency (which may be different from your desired specialty – you can apply to any specialty with open positions during SOAP). If you have a weakness in your application that can be improved upon it may be realistic to consider a competitive specialty and preliminary/transitional (TY) positions. Keep in mind that prelim/TY positions are very competitive during SOAP since most if not all applicants who initially applied to a competitive specialty (e.g. OBGYN, ortho, anesthesia, radiology) and are unmatched apply to these positions.

Within the SOAP communication rules, I recommend reaching out to your letter of recommendation writers and mentors. These are people who have advocated for you previously and can be a great resource for advice and support. Additionally, you need personal support from loved ones and friends. Don’t be afraid to ask for help navigating SOAP rules and regulations which can be difficult to work through on your own. 

Lastly, if you remain unmatched after SOAP or if you match prelim/TY year, be sure to reach out to the programs you interviewed at. Briefly let them know your situation and request a meeting to discuss feedback on your application. This will provide you with additional ways to improve your application moving forward and make the best out of re-applying.

Best of luck and feel free to reach out to me on Instagram, @curleysurgeon, with any questions.

SOAP Match Statistics

In 2024, 2,575 unfilled positions were placed in SOAP and 2,399 (93.2%) were filled.

The most common categorical specialties filled through SOAP included Family Medicine (594 positions), Internal Medicine (460 positions), Emergency Medicine (130 positions), Pediatrics (232 positions), and Surgery (560 positions).

While there may have been stigma in the past regarding SOAP matches, the perception has shifted significantly. A SOAP match represents a legitimate and valuable route into residency training. Residency programs are primarily interested in an applicant’s qualifications, performance, and fit for the program, rather than the specific pathway through which they matched. 

Once in a residency program, your performance, skills, and professional conduct become the most important factors determining your reputation and opportunities for advancement.

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