Road to Residency: The SOAP

We have gone through the typical process to get into a residency program. But what happens when things do not go according to plan and the isn’t a Match? In this post from the Road to Residency Series we will be going through the process of the SOAP. Also from the NRMP, the Supplemental Offer and Acceptance Program (SOAP) is an alternative way to get a residency position in the US. Since I matched and did not go through this process, I have a Guest Writer for today’s post on how to SOAP for Residency.

Melissa is a 2017 graduate of The University of Medicine & Health Sciences, St. Kitts. She will be starting an Internal Medicine residency in July in Philadelphia. A Jersey girl with Cuban roots she loves working out, watching baseball/softball, and hanging out with friends/family. Follow her journey on Instagram and Twitter!

For all those fourth years that Match, the Monday of Match Week is pretty easy and full of celebration. But, what happens if you don’t match? Aside from your life becoming very overwhelming for a few days, there is still hope. That hope comes in the form of the Supplemental Offer and Acceptance Program, or SOAP. But, what actually happens during the SOAP? Here is the scoop from someone who’s been there!

“We are sorry. You did not match into any position”

The Friday before Match Week, everyone receives an email notifying them if they are SOAP eligible or not. The eligibility criteria is pretty straight forward. You must be registered for the Match, be eligible to begin residency on July 1, and be partially matched or fully unmatched. Most people will end up being eligible, but Monday is when you find out if you will be participating or not.

Getting the email that reads, “We’re sorry, you did not match to a position”, is a huge blow. There will be tears, there will be anger, and there will be a whole bunch of other emotions that come with it. However, there is work to do because the SOAP process begins that same day. It is important to take some time to yourself to work through your emotions after receiving the email, but you also need to get ready to begin the daunting task of going through SOAP.


The SOAP process begins at 12 pm on Match Monday. This is when MyERAS becomes available again for applicants to begin applying to unfilled programs. You will find the list of unfilled programs on the NRMP R3 website. Now, it is important to keep in mind that you only get 45 applications for SOAP. As such, it is important to have a strategy in mind. Your strategy depends upon which programs are unfilled and which specialty you want to apply for. Usually, the specialty with the most positions in SOAP is Preliminary Surgery. Alternatively, you will also find Family Medicine and Internal Medicine positions. The other specialties tend to have much less openings available. If your school has provided you with an advisor, it is important to TRY to contact that person. The purpose is that they can help you decided where your 45 applications would be best used.


Beginning the process

Programs can begin reviewing application at 3 pm on Match Monday, so you have 3 hours to get everything together in MyERAS. This timeline is important to remember, especially if you are switching up the specialty that you applied to in the Main Match. It will likely not be possible to get all new letters of recommendation for SOAP. Regardless, some people do switch up their personal statements for the new specialty. Also, you cannot have anyone reach out to these unfilled programs on your behalf before a program interviews you. So it is important that you do not ask anyone to call hospitals for you. It is a huge violation and BOTH YOU AND YOUR contact will be penalized!


Programs can begin contacting applicants any time after 3 pm on Monday. Most interviews are conducted by phone, with a few programs setting up Skype calls. You need prepare to receive calls at any time. If you are on a rotation, it is important to let your preceptor know what is going on so that you are able to answer your phone quickly. If you do get a call, it is important to just relax and be yourself. Programs will be able to interview until Wednesday morning. It is ok to feel extremely stressed out while observing your phone all day. It is extremely rare that a SOAP offer is made without an interview, but there is the rare occasion where that occurs so don’t lose complete hope if you don’t hear anything!

After interviews

The first round of offers begins on Wednesday at 12 pm. Applicants do not create a rank order list for SOAP. In contrast to the Main Residency Match, it is possible to receive more than one offer on the SOAP. If you get an offer, you have 2 hours to decide whether or not you will accept. Keep in mind that if you turn down the offer, there is no guarantee you will receive more interviews or offers in the next round of SOAP. There are 3 rounds of offers in SOAP: 12 pm Wednesday, 3 pm Wednesday, and 9 am Thursday.

SOAP Offers

In between these rounds of offers the list of unfilled programs is updated. So, if you saved any of your applications you can apply to new programs in between rounds. Programs will also conduct more phone interviews between rounds. As such you must be available to answer phone calls in between rounds. Keep in mind that you cannot have anyone contact a hospital that has not contacted you first. That rule DOES extends to in-between offer rounds.

What’s Next?

So, what happens if you do not receive an offer in any of the rounds? At 12 pm Thursday the final list of unfilled programs is posted on the R3 website. At this point, you are able to contact these programs however you choose to (email, phone, etc.). It is at this point that you CAN have mentors contact programs on your behalf. Once SOAP is over, it becomes even harder to obtain a position but there are websites like Residency Swap and FindAResident where unfilled positions are listed. These websites do have a fee, but they allow you to set up email alerts so that you are notified as soon as a position is listed.

The SOAP process is an extremely stressful thing to go through and is very emotionally draining, but there are success stories! As a mode of transparency I will say that SOAP is generally geared towards American Medical grads. So to any IMGs (US citizens or otherwise) reading I want to be honest and say that the chances for you will be slimmer. I am a US-IMG and I was unsuccessful in my experience with SOAP. Honestly, the best way to be prepared for SOAP is to familiarize yourself with the process. You can do this by reading all of the material on the NRMP website and other applicant’s experience. Hopefully it is a process that most of you will not have to go through!

If you are unsuccessful in your SOAP attempt, please know that this is not a reflection on you or the doctor you will be become. Take some time to grieve, but make sure to remember that this small obstacle will not define you and take the opportunity to learn, grow and prepare for the next ERAS cycle.

Thanks for stopping by!



If you have found this helpful, share this post so that others can benefit as well!

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6 comments so far.

6 responses to “Road to Residency: The SOAP”

  1. ROSANNA says:

    Sounds very helpful, thank you!
    Have a lovely weekend 🙂
    Rosanna x

    • Jani says:

      Thank you! I am glad you found this helpful, as someone who know people who had to go through this and they felt so alone and lost I really wanted to make this series as complete as possible. XO

  2. Such a helpful but also inspiring post! Its definitely something every medical student should read before Match week so as to be ready.
    María Eugenia

    • Jani says:

      Thank you! I wanted The Road to Residency series to be as complete as possible and including the other side was something very important for me. Glad you found it insightful and helpful!

  3. Juliet says:

    Very insightful post! We actually don’t have the same match process in the UK! But I think its very helpful of you to do a post on this, unfortunately it’s a sad reality that all students must prepare for.

    Juliet x

    • Jani says:

      Thank you! I definitely intended for it to be that way, it’s unfortunate that the system is so flawed when there is so much need. But if we can better prepare, maybe we can increase our chances of success! Thanks for the love!

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