SOAP stands for the Supplemental Offer and Acceptance Program, a process that gives medical students a second chance at landing a residency position after they fail to match during Match Week. Run by the National Resident Matching Program (NRMP), SOAP replaced the older, informal “Scramble” system and provides a structured way for unmatched applicants to apply to residency programs that still have open spots. For medical students, “SOAPing” is one of the most stressful experiences in training, compressing what normally takes months of applications into roughly three days.
How SOAP Works
On the Monday of Match Week, medical students learn whether they matched to a residency program. Those who didn’t match, or who only partially matched (for example, securing a preliminary first year but not an advanced position), become eligible for SOAP. The process runs from Monday morning through Thursday evening, giving applicants a narrow window to find an open position.
Once notified, applicants log into the ERAS (Electronic Residency Application Service) portal and can apply to up to 45 programs that still have unfilled spots. You can reapply to programs you already applied to earlier in the cycle or target entirely new ones. Programs then review these applications and extend offers through a series of structured rounds managed by the NRMP. When you receive an offer, you can accept or reject it, but the rounds move quickly, and open positions disappear fast.
Strict Communication Rules
One of the most important rules during SOAP is that applicants and their representatives cannot contact programs first. You have to wait for a program to reach out to you. This policy exists to keep the process fair and prevent applicants from overwhelming program directors with calls and emails. Violating this rule can result in a Match violation, which carries serious consequences including potential disqualification.
This restriction makes SOAPing feel especially passive and anxiety-inducing. Unlike the regular application cycle, where you can reach out to express interest in a program, SOAP requires you to submit your applications and then wait.
Who Is Eligible
To participate in SOAP, you must have been registered for the NRMP Main Residency Match and be able to start graduate medical education on July 1 of that year. Beyond that, eligibility depends on your training background.
- US MD and DO seniors must be enrolled in an accredited medical school and have their eligibility verified by their school before the rank order list deadline.
- Previous graduates of accredited US, osteopathic, or Canadian medical schools can participate as independent applicants, but they also need eligibility verification completed by the deadline.
- International medical graduates (IMGs) must have completed all examination, clinical skills, and communication requirements for ECFMG certification before the deadline. IMGs who haven’t finished these requirements by the cutoff cannot participate.
Which Specialties Have Open Spots
Not every specialty has significant availability during SOAP. The positions that go unfilled tend to cluster in certain fields. Based on recent match data, the specialties filling the most residents through SOAP were family medicine (753 positions), preliminary surgery (534), internal medicine (347), pediatrics (139), and emergency medicine (64).
This means if you’re SOAPing, your options will likely skew toward primary care and preliminary positions rather than competitive specialties like dermatology, orthopedic surgery, or plastic surgery. Many applicants who originally applied to a competitive specialty find themselves pivoting to a different field entirely during SOAP. For some, this means accepting a preliminary year to stay in training while reapplying to their preferred specialty the following cycle.
The Numbers Behind SOAP
In 2024, a total of 2,575 positions were available through SOAP. The process filled 2,399 of them, a fill rate of 93.3%. That sounds encouraging, but it’s important to understand that the number of SOAP-eligible applicants typically exceeds the number of available positions. Not everyone who SOAPs will secure a spot, and the 45-application limit means you need to be strategic about where you apply.
What SOAPing Actually Feels Like
For most medical students, Match Week is supposed to be a celebration. SOAPing turns it into a crisis. You learn on Monday morning that you didn’t match, and by that afternoon you need to have identified programs with open positions, updated your personal statement (possibly for an entirely different specialty), gathered any additional letters of recommendation, and submitted applications, all while processing significant disappointment.
Medical schools typically have dedicated support teams that activate during SOAP to help unmatched students. Advisors assist with application strategy, help rewrite personal statements on the fly, and coordinate with faculty who can provide rapid letters of support. The role of your medical school during this period is critical, since students going through SOAP alone are at a significant disadvantage.
The offer rounds themselves happen over the following days. Programs review applications, conduct phone interviews (sometimes lasting only a few minutes), and then submit offers through the NRMP system. Each round has a set time window, and if you receive an offer, you typically need to decide quickly. Accepting an offer is binding, just like the regular Match.
Partially Matched Applicants
SOAP isn’t only for students who completely failed to match. Partially matched applicants also participate. This commonly happens when someone matches into a preliminary PGY-1 position (a single training year, often in surgery or medicine) but didn’t secure a categorical spot that would carry them through full residency training. These applicants can use SOAP to try to find an advanced or categorical position to pair with their preliminary year, or to find an alternative path forward.
Being partially matched adds a layer of complexity. You already have a commitment for your first year, but you still need a long-term training position. Some partially matched applicants choose to complete their preliminary year and reapply to the regular Match the following cycle rather than accepting a SOAP offer in a specialty they’re not interested in.
Preparing for the Possibility
No one applies to residency expecting to SOAP, but preparation can make a real difference if it happens. Practical steps include having a backup personal statement drafted for at least one alternative specialty, identifying letter writers who could turn around a recommendation quickly, and keeping your ERAS application materials current. Some students also research which programs historically participate in SOAP so they have a head start on identifying realistic options.
The students who navigate SOAP most successfully tend to be flexible about specialty, geographic location, and program prestige. A position secured through SOAP is still a residency position, and many physicians who SOAPed go on to practice in their preferred specialty after completing additional training or transferring programs later in their careers.