You may be wondering, “What happens if a medical student does not match with a program they apply for?” Picture it’s the Monday morning of Match Week, and you open your computer to see your Match Day results, only to find that you haven’t matched with any of the residency programs you applied for. Many emotions can arise in this situation. However, your career is not over. Suddenly, you receive another notification from the National Residency Match Program (NRMP) informing you that you’re eligible for the Supplemental Offer and Acceptance Program (SOAP). So, what is SOAP, and how is it different from the regular applications you sent for the national Match? In this blog, we will address these questions and provide an analysis of the advantages and disadvantages of searching for a residency spot through the NRMP’s second-chance program.

What is the NRMP’s SOAP Program?

It’s important to note that medical students aren’t the only ones hoping for the best on Match Day; the residency programs also want to fill their positions. The NRMP’s Supplemental Offer and Acceptance Program provides a solution for both parties by connecting unmatched applicants with unfilled residency programs. It ultimately acts as a second Match Day for medical students who didn’t receive an offer during the initial Main Residency Match. 

Who is Eligible for SOAP?

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SOAP eligibility is granted to applicants who were able to participate in the Match. For an International Medical Graduate (IMG), this means you must have: 

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• Registered for the NRMP’s Rank Order List (ROL) and created a list of your preferred residency program rankings before the deadline (Feb. 28). 
• Completed all examinations to be certified by the Educational Commission for Foreign Medical Graduates (ECFMG) before the ROL deadline. 
• Met and verified all eligibility requirements as designated by the Accreditation Council for Graduate Medical Education (ACGME).

What does the SOAP process look like?

The SOAP process consists of multiple rounds of applications, interviews, and offers. This all takes place from Monday through Thursday of Match Week, and residency programs with unfilled positions continue to promote available spots to unmatched applicants throughout this timeframe. 

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Similar to the standard matching process, applicants apply to these programs using an Electronic Residency Application Service (ERAS) application or the program’s application service of choice. A SOAP application itself is essentially the same as an application for the Main Residency Match, but the key distinction is they operate on different timelines. The SOAP cycle moves a lot faster than the initial Match, and programs will be in constant contact with applicants throughout the process to quickly fill their positions.

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Typical SOAP rounds follow this process: A program receives your application, requests an interview, and then offers a position if they think you’re a good fit. Applicants then have two hours to either decline or accept the offer. Each two-hour period constitutes a round. Although applicants can choose to go through as many rounds as they want, many medical professionals believe that unmatched applicants should always take the first offer they can get to avoid leaving the Match empty-handed.

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For the 2024 Match, the NRMP has established four rounds for SOAP, following the schedule below:

• March 11: Eligible applicants can access the list of unfilled programs and begin preparing applications in the Association of American Medical Colleges (AAMC) ERAS system.
• March 12: Programs begin reviewing SOAP applications and may contact applicants to begin the interview process.
• March 14: Four, two-hour rounds of SOAP take place starting at 9:00 a.m. EDT and ending at 8:00 p.m. EDT and applicants can accept or decline the offers they receive.
• March 15: Applicants can view their SOAP residency match results.

SOAP’s Pros

The biggest pro the SOAP offers is a second chance to match with a residency program. You are free to apply to any of the available programs that may interest you. 

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Since it’s part of the NRMP’s Match services, you don’t need to register for SOAP. You are automatically enrolled in the program if you are eligible and haven’t found a match.

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Another benefit that SOAP applicants receive is free ERAS applications. Yes, you read that right. If you take advantage of SOAP and apply to second-chance programs that accept ERAS applications, you won’t have to pay an application fee.

SOAP’s Cons

The largest con is that you may not match with a program offering the specialty of your choice. However, it’s important to note that this will be your last chance to secure a residency before the next Match cycle, and many applicants are willing to forego this luxury to secure a coveted position as a medical resident. 

Additionally, only ACGME-accredited programs can participate in the Main Residency Match and SOAP, so even if you do not get matched with your desired specialty, you can rest assured that the program you go into still offers a certified graduate medical education.

Application Tips

Although you didn’t match with your preferred programs, SOAP offers you another chance to revisit your applications and present yourself as a stronger candidate than you were the first time around. 

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Many medical professionals suggest performing a Strengths, Weaknesses, Opportunities and Threats, or SWOT, analysis during this period. Although not all applications have weaknesses, most probably will. Reanalyze your test scores and abilities to see if certain specialties are realistic, and apply for programs that fit your strengths. You may find that your test scores or clinical experiences fit other specialty programs better than the ones you originally applied for. 

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You should also keep a positive mindset. Rather than viewing SOAP residency as a solution for rejection, see it as a chance to prove yourself in a new specialty. You’ve been given a second chance, and you can now make the most of it. Programs are just as eager to fill positions as applicants are to find a residency match. This should give you hope to find an alternative match before SOAP ends.

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What Happens to Medical Students Who Don’t Match During SOAP?

If you don’t match with a program after SOAP, you can always try again after a year or two, depending on the additional experience you think you need. Some graduates may want to perform another clinical clerkship to receive more hands-on experience before applying for the match again, while others may look for jobs in clinical settings. You may also consider retaking exams to achieve better scores. This depends on what you feel you might need to work on. 

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Whatever you think your path may be, CHHA is here to help you make the best decisions for your career along the way. Apply with us today to match with a clerkship program and gain the experience you need to become a competitive applicant before the next Match.

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