Everything You Need to Know About SOAP (Supplemental Offer and Acceptance Program)

As you wait to find out whether your own Match Day story has a happy ending, here’s the scoop on the Supplemental Offer and Acceptance Program (SOAP).
SOAP is made up of a series of rounds in which participating programs seek to fill their unfilled residency positions. Keep in mind, just getting an email before Match Day about your eligibility for SOAP doesn’t indicate whether or not you’ve matched.
Here’s what you need to know about the program:
 

Your eligibility for SOAP is based on National Resident Matching Program (NRMP) requirements. You’ll need to:

• Register with the Main Residency Match.
• Be eligible to enter graduate medical education programs on July 1 in the year of the Match.
• Be partially matched or fully unmatched on Monday of Match Week.

Everyone who is SOAP-eligible receives an email confirming this the Friday prior to Match Week.

If you’re eligible for SOAP, you can see the List of Unfilled Programs in the NRMP Registration, Ranking, and Results (R3) system starting at 11 a.m. EST on Match Day: the Monday of Match Week. You can begin submitting your applications through the Electronic Residency Application Service (ERAS) at 2 p.m. EST. You’ll be able to apply only for the categorical, preliminary, and/or advanced unfilled positions that you’re eligible for.
SOAP begins at 11 a.m. EST on Monday of Match Week when applicants find out whether or not they’re matched.
You will have until 2 p.m. EST to submit up to 45 applications. At 3 p.m. EST, programs have access to the applications and begin the “interviewing” process, which can mean a phone call, video, or in-person [if local] interview. There are three Offer rounds—12 p.m. EST & 3 p.m. EST on the Wednesday and 9 p.m. EST on the Thursday of Match Week. The offers are based off of the program’s rank list
If you are extended an offer during the first round and decline it, you will not be offered the spot again. After the last offer round, the remaining unfilled spots from both SOAP and non-SOAP programs are released. At this point, applicants can start to reach out to programs directly. During the SOAP process, it is a violation to contact programs outside of ERAS—don’t do it!

Programs can contact you for a residency interview after they receive your ERAS application. Keep in mind that, as an applicant, you’re not allowed to initiate contact with programs during SOAP. The programs will contact you first by phone or email and conduct brief phone interviews.
Some programs will want to have video interviews using Skype or, if you’re local, they may offer to have in-person interviews. No matter what the format, be ready during your residency interview to show that you’re the right candidate for the program.


Many unmatched applicants can secure a position through SOAP. It may not be in your initial specialty or desired location. However, starting at a program offers the best option for switching specialties or re-applying the following year. Or you may find that you enjoy the specialty you matched at and complete the program!

Even as a U.S. IMG [e.g. U.S. citizen at a Caribbean medical school], SOAP can be a frustrating process unless you already have a relationship with a program. Non-U.S. IMGs have even fewer resources to navigate the system, which can make it hard to optimize one’s strategy for securing a spot.
If your goal as an IMG is to practice medicine in the U.S. regardless of specialty, then applying to preliminary medicine/surgery, as well as open categorical primary care specialties, may be your best option. Showing that you’re a strong resident in a one-year position will probably open more doors for re-application the following year.

If you remain unmatched after the SOAP, you can use the list of unfilled spots to reach out to programs directly. There are typically very few programs left at this point and most programs will have either filled the spot by the time you’ve reached out to them or decide to leave it unfilled. At this point, it doesn’t hurt to reach out to any program you’d be open to training at. Although, the number of offers extended at this point are minimal.
Unmatched applicants after Match Week will need to reflect upon deficiencies in their application in order to determine the best path for re-application. Certain aspects cannot be changed—clinical grades and USMLE scores—but letters of recommendation, research, and networking are all areas that can be improved upon.
You may consider another advanced degree [e.g. MPH, MBA]. However, this also generally confers more debt. Reach out to mentors and ask for frank feedback on your application. It’s important to reflect upon your application and move forward.
After matching, heed our advice and take Step 3 before starting residency. Do it while you have time to study!