HealthMarch 03, 2020

The dirt on SOAP: The supplemental offer and acceptance program

By: Michelle A. Finkel, MD
Everyone knows the competition for residency programs is fierce. Improve your chances by learning about the Supplemental Offer and Acceptance Program.

With Match Day 2020 fast approaching, anticipation is high for residency program applicants. While everyone hopes for the best, it pays to prepare now for a “plan B.” Read on for what you need to know about the National Resident Matching Program®’s (NRMP) Supplemental Offer and Acceptance Program® (SOAP).

What is SOAP?

The Supplemental Offer and Acceptance Program is a standardized process affording unmatched candidates the opportunity to find residency positions. SOAP consists of three rounds during which residency programs make offers to eligible applicants who did not match for residency or who partially matched. That latter category includes candidates who matched to a preliminary position (needed prior to entry into some advanced specialty programs) or a categorical one (which offers the full training required for a specialty’s board certification) but not both.

To be SOAP-eligible, applicants must:

  1. Be registered with the NRMP for the main Match.
  2. Be qualified to enter graduate medical education by July 1, verified by the candidate’s medical school or by the Educational Commission for Foreign Medical Graduates® (ECFMG).
  3. Be partially or fully unmatched on the Monday of Match Week.

Before SOAP was implemented, those who did not match to residency programs were invited to participate in the “Scramble,” a haphazard process in which many unfilled programs accepted applications through both the official Electronic Residency Application Service® (ERAS) system and informal means like direct notes and phone calls. This dual pathway led to chaos, with many applicants submitting through ERAS while faxing and calling programs at the same time. Strangely, no organization was responsible for the Scramble, adding to the chaos. After the process was met with repeated criticism, the NRMP took over, implementing SOAP during Match Week 2012.

How does SOAP work?

Match Week means a packed schedule for SOAP applicants. How does it break down?

1. Residency applicants find out match status

At 11 a.m. EST on the Monday of Match Week, applicants find out via email whether they matched to a position. This information can also be found on the NRMP’s web-based Registration, Ranking, and Results® (R3) system. Note that candidates only find out if—but not where—they matched at this time. Simultaneously, SOAP-eligible unmatched and partially matched applicants are given access to the List of Unfilled Programs through the R3 system.

2. SOAP-eligible candidates prepare applications

At 12 p.m. on Monday, SOAP-eligible candidates can start preparing applications for open slots. In contrast to the helter-skelter Scramble, the only way for SOAP candidates to apply for unfilled programs is to do so through ERAS; there are no permitted back channels. Candidates are allowed to submit up to 45 applications. Those who are partially matched can only see and apply to the programs that are appropriate for them. Say someone has an advanced Match in dermatology but no Match for their PGY-1 year. She can only apply through SOAP for the preliminary/transitional year she does not have.

At 3 p.m. on Monday, unfilled residency programs can view SOAP applications in the ERAS system and can contact applicants. These programs then start interviewing candidates, usually by phone or video.

Unlike with the Match, residency candidates do not submit a preference list during SOAP—only programs do, on Tuesday of Match Week. This highlights a drawback of SOAP for partially matched candidates, who are unable to preferentially coordinate programs based on geographic proximity.

3. SOAP applicants discover match status

The real meat of the process starts on Wednesday, when the SOAP rounds begin. In each round, residency programs offer spots to their desired SOAP-eligible applicants.

  • Round 1: At 12 p.m., the first round begins; candidates begin receiving offers through the R3 system. By 2 p.m., applicants must accept or reject these Round 1 offers.
  • Round 2: Round 2 starts at 3 p.m., when applicants can view new offers through the R3 system. They then have until 5 p.m. to accept or reject these offers.
  • Round 3: Finally, on Thursday, Round 3 offers start at 9 a.m. and must be accepted or rejected by 11 a.m., terminating the SOAP process.

Just like the Match, positions accepted during SOAP are a binding, legal commitment, so SOAP agreements should be taken seriously by both applicants and program directors.

4. Unmatched applicants can contact unfilled programs

At 12 p.m. on Thursday, all applicants who are still unmatched or partially matched after the SOAP process can access an updated list of unfilled programs (including those that did not participate in SOAP) through the R3 system. All candidates—including those who were not SOAP-eligible—can contact these programs directly.

For additional SOAP details, watch the NRMP’s video on the process and review the NRMP’s hour-by-hour 2020 Match Week & SOAP Schedule.

As complicated as the Supplemental Offer and Acceptance Program may seem, it is a well-crafted means of uniting applicants who did not match to residency with unfilled programs, and it is certainly an improvement over the Scramble, which left many candidates exasperated. All applicants hopes they won’t have to participate in SOAP, but understanding the process in advance affords a huge advantage to those who might need to go through it. In the application process, it’s better to bring an umbrella and hope it doesn’t rain than get soaked in the unexpected storm.

Michelle A. Finkel, MD