Mastering SOAP: Strategies for Residency Success in the Match Process

The Insider’s Playbook for SOAP: Advanced Strategies for a Successful Post-Application Match

Entering the residency Match process is the culmination of years of intense effort—exams, clerkships, sub-internships, research, and personal sacrifices. When Match Week arrives and the email says “You did not match,” it can feel devastating and disorienting.

Yet, this is exactly where the Supplemental Offer and Acceptance Program (SOAP) becomes critical.

SOAP is not a consolation prize; it is a structured, competitive process that successfully places thousands of applicants into residency positions every year. With the right preparation, strategy, and mindset, SOAP can absolutely be your path to a strong residency training experience and a fulfilling medical career.

This enhanced guide breaks down the SOAP process in depth and gives you a practical, step-by-step “playbook” for success—specifically designed for unmatched medical students and graduates navigating the residency Match process.

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Understanding SOAP: Key Concepts, Rules, and Timeline

The first step in mastering SOAP is understanding exactly how it works and how it differs from the main Match process.

What Is SOAP and Why Does It Matter?

The Supplemental Offer and Acceptance Program (SOAP) is a service of the National Resident Matching Program (NRMP) designed to efficiently fill unfilled residency positions with eligible unmatched or partially matched applicants during Match Week.

SOAP connects:

• Unmatched applicants (or those who are only partially matched, e.g., matched to an advanced position without a prelim year)
• Residency programs with unfilled slots after the main Match ranking process is complete

For many applicants, SOAP is the only remaining formal route to secure a residency position for the upcoming academic year. Understanding the rules and using them to your advantage is essential.

Basic Eligibility Criteria

To participate in SOAP, you must:

• Be registered for the NRMP Match
• Be unmatched or partially matched when Match Week begins
• Be SOAP-eligible as determined by NRMP (you’ll see this status in your NRMP account)
• Have certified and submitted a rank order list (for most categories) or be otherwise eligible under NRMP rules

If you are not SOAP-eligible, you cannot contact programs about unfilled NRMP positions until after SOAP concludes (when programs may choose to fill remaining spots outside the Match).

High-Level SOAP Timeline (Subject to Annual NRMP Updates)

While specific times change each year, the basic Match Week structure is:

1. Monday of Match Week

   • 11:00 AM ET: Applicants learn whether they are fully matched, partially matched, or unmatched.
   • Unmatched/partially matched SOAP-eligible applicants get access to the List of Unfilled Programs via NRMP.

2. Monday–Tuesday

   • Applicants identify programs and prepare ERAS applications (or equivalent system for some specialties).
   • No contacting programs outside of permitted channels. Programs cannot initiate contact until the designated time.

3. Tuesday–Thursday (SOAP Rounds)

   • Programs review applications and conduct interviews (often virtual or phone-based).
   • NRMP runs several offer rounds where programs extend a limited set of offers, and applicants may accept only one.

4. Thursday–Friday

   • Remaining unfilled positions after SOAP may be listed publicly.
   • At this point, applicants and programs are permitted to communicate freely outside of SOAP.

Always verify the exact timeline each year on the NRMP and ERAS websites, as rules and details can change.

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Strategic Preparation for SOAP: Laying the Groundwork Before and During Match Week

You often have only hours—not days—to act during SOAP. Thorough preparation before Match Week can dramatically change your outcome.

1. Honest Assessment of Your Application and Match Strategy

When you learn you are unmatched or partially matched, your first step is reflection, not panic. A clear, objective review of your application will guide your SOAP strategy.

Ask yourself, ideally with an advisor or dean:

• Specialty choice

  • Did you apply to a highly competitive specialty without a backup?
  • Did you apply to enough programs in that specialty?
  • Did you dual-apply (e.g., IM + another specialty) if appropriate?

• Academic metrics

  • Were your USMLE/COMLEX scores below the typical thresholds for your chosen specialty?
  • Any exam failures or red flags on your record?
  • Any leave of absence or professionalism concerns?

• Experiences and alignment

  • Did your clinical experiences and letters align with your chosen specialty?
  • Did you have enough home or away rotations in that field?
  • Does your CV show consistent commitment to the specialty you’re targeting?

• Personal statement and narrative

  • Was your reasoning for the specialty compelling, specific, and well written?
  • Did your narrative show growth, resilience, and maturity?

Beating yourself up is unhelpful. Instead, use this reality check to:

• Decide whether to stay with your original specialty in SOAP or broaden to others (e.g., internal medicine, family medicine, psychiatry, pediatrics, prelim-year positions).
• Identify what you must explicitly address in interviews (e.g., exam failures, gap years, switch in specialty).

2. Engage Early and Strategically with Your Support Network

One of the most powerful tools in SOAP is who is willing to actively advocate for you.

Key people to involve:

• Dean or student affairs office

  • Most schools have a SOAP response team.
  • They may have direct communication lines with program directors.
  • They can help prioritize your list and support you with “back-channel” communication when appropriate.

• Specialty advisors and program directors

  • Even if you’re shifting specialties, speak to faculty in your new target field.
  • Ask for honest feedback: Where do I realistically have a chance?

• Letter writers

  • Let them know your SOAP plan.
  • Ask if they’re comfortable emailing programs directly during SOAP to vouch for you when appropriate.

• Recent graduates and residents

  • Alumni who matched through SOAP can provide practical, real-time guidance.
  • They might also flag programs where they know there will be unfilled positions.

Make your ask concrete:

• “I’m planning to apply mainly to community internal medicine programs and prelim surgery positions during SOAP. Would you be willing to review my updated personal statement and, if appropriate, email programs X and Y once they appear on the list?”

3. Crafting Targeted SOAP Application Materials

Your application documents need a SOAP-specific refresh. Programs know you are applying during SOAP; you don’t need to hide that—but you do need to project clarity and confidence.

Updated Personal Statements

Prepare at least 2–3 versions of your personal statement:

• One for your primary SOAP specialty (e.g., Internal Medicine)
• One for alternate specialties (e.g., Family Medicine, Psychiatry)
• Optionally, a separate one tailored for preliminary or transitional year positions

Key elements:

• A concise explanation (if needed) of any significant shift in field
  Example: “While I initially applied in general surgery, my experiences on medicine wards and continuity clinics have clarified that my true strengths and long-term professional goals align most with internal medicine…”

• Emphasis on:

  • Teachability and work ethic
  • Teamwork and communication
  • Reliability, resilience, and professionalism

Avoid:

• Overly detailed discussion of why you didn’t match
• Blaming others or systems
• Dramatic or defensive language

Streamlined, Up-to-Date CV

Your CV should be:

• Current through Match Week (include late electives, volunteer roles, projects)
• Structured for quick scanning:
  • Easiest-to-read formatting
  • Clear sections (Education, Exams, Clinical Experience, Research, Leadership, Volunteer Work)
• Focused on clinical readiness and professionalism

Highlight:

• Sub-internships, strong clerkship evaluations, leadership roles, and teamwork skills
• Any recent improvements (e.g., strong Step 2 after weaker Step 1)

Letters of Recommendation

During SOAP, you typically use the letters already in ERAS, but you can sometimes add or re-prioritize letters.

If time allows:

• Ask for one new letter that speaks directly to:
  • Clinical performance
  • Reliability
  • How you responded to adversity or feedback
• Choose letter writers who:
  • Know you well
  • Are willing to go the extra mile, sometimes emailing program directors directly (within NRMP guidelines)

4. Researching Unfilled Programs Strategically

Once the List of Unfilled Programs becomes available:

1. Sort by specialty
   Identify:

   • Programs in your primary specialty
   • Viable backup specialties
   • Prelim and transitional year options

2. Look up each program quickly but efficiently:

   • Review their website for:
     • Mission and patient population
     • Program size and structure
     • Any stated priorities (underserved care, research, community practice, etc.)
   • Check recent trends:
     • Are they historically IMG- or DO-friendly?
     • Do they emphasize exam scores or holistic review?

3. Prioritize:

   • Programs that realistically fit your profile and goals
   • Locations where you have geographic ties (family, prior schooling, rotations)
   • Programs where your school or mentors have existing relationships

Document this in a simple spreadsheet or tracker:

• Program name
• Specialty / track
• Location
• Contact info (program coordinator, PD)
• Any connections (alumni, faculty)
• Application status (sent / responded / interview)

This organization will keep you focused when the SOAP timeline gets hectic.

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Executing the SOAP Process: Tactical Moves During Match Week

Once the SOAP window opens, every hour matters. You need a clear operational plan.

1. Apply Promptly but Not Blindly

SOAP is not technically first-come, first-served, but programs do begin reviewing as soon as applications appear. You should:

• Have your list of targeted programs ready before the unfilled list opens.
• Apply early on Day 1 with tailored materials for each specialty.
• Avoid sending random, unfocused applications to every single open spot; that can dilute your narrative and lead to misalignment.

If ERAS caps the number of applications you can send during SOAP (as it has in recent years), be very strategic in who receives your initial batch.

2. Communicating with Programs: What Is and Isn’t Allowed

NRMP has strict rules about communication during SOAP. Always confirm current rules each year, but in general:

• Applicants cannot initiate contact with programs about unfilled positions before or during SOAP, unless the program has first contacted them.
• Your medical school officials and advisors can often reach out on your behalf where appropriate. Use this channel strategically.
• Once a program contacts you (e.g., email, call), you can respond and interact with them for interviews and follow-ups.

Be professional, prompt, and organized in all communications.

3. Acing SOAP Interviews: Focused, Clear, and Honest

SOAP interviews are often:

• Shorter (sometimes 10–20 minutes)
• More direct
• Conducted by phone or video with less advance notice

Expect key questions such as:

• “Can you tell me briefly about yourself and why you’re interested in our program?”
• “Why did you not match, and what have you learned from the process?”
• “Why are you now applying to [this specialty/our program]?”
• “How do you handle stress, long hours, or setbacks?”

Prepare:

• A 2–3 sentence “elevator pitch” about who you are and what you’re seeking.
• A non-defensive, concise explanation of why you didn’t match:
  • Acknowledge the issue (exam score, competitiveness of specialty, limited applications).
  • Emphasize what you’ve done to address weaknesses.
  • Signal readiness and growth.

Example framework:

“I initially applied exclusively to [specialty], which is highly competitive. My Step 1 score was below the average for that field, and I did not add a backup specialty. While I’m disappointed in that outcome, the process has pushed me to reflect deeply on my strengths and career goals. My experiences on [X rotation] confirmed that I thrive in [new field], and I’m excited for the opportunity to contribute as a [specialty] resident in a program like yours.”

Have specific reasons for each program you’re interviewing with:

• Patient population
• Teaching culture
• Location / family ties
• Program strengths aligned with your goals

4. Evaluating and Accepting SOAP Offers

SOAP proceeds in multiple offer rounds. Key rules:

• You can receive zero, one, or multiple offers in a round.
• If you receive an offer, you have a very short time window (often 2 hours) to accept or reject.
• Once you accept an offer, you are bound to that program (like the main Match).

To prepare:

• Before offers start, define with your advisors:
  • Your minimum acceptable outcomes (e.g., “Any categorical FM spot in [regions],” or “Any prelim year as long as I can reapply next cycle.”)
  • Programs you feel strongly you would not attend, even if it means reapplying next year.

Balance:

• Realism (securing some residency training is often much better than none)
• Long-term fit (location, specialty, support structure, visa issues if applicable)

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Flexibility, Mindset, and Wellness: Protecting Yourself During SOAP

SOAP is not just a logistical challenge; it is emotionally intense. Your mindset will influence your performance and decisions.

1. Being Flexible Without Losing Your Long-Term Vision

Flexibility can open doors:

• Consider adjacent specialties that match your strengths and interests (e.g., internal medicine vs family medicine, pediatrics vs med-peds, psychiatry vs neurology).
• Consider preliminary or transitional year positions if categorical spots are limited. A strong prelim year can:
  • Strengthen your clinical skills
  • Provide new letters and mentorship
  • Improve your chances when reapplying

However, also be clear about:

• Which options may limit your future goals (e.g., very narrow subspecialty interests)
• What you are—and are not—willing to sacrifice in terms of geography, lifestyle, or visa considerations.

2. Staying Organized Under Pressure

Create a simple SOAP command center for the week:

• Spreadsheet with all programs and statuses
• Email templates for quick responses
• Calendar or alarm reminders for:
  • Interview times
  • Offer round windows
• A printed or digital checklist to avoid missing steps

This structure reduces anxiety and prevents costly errors.

3. Protecting Your Mental Health

Not matching can feel like a personal failure, even though many systemic factors are out of your control. Normalize your experience:

• Many strong, successful physicians did not match on their first try and/or matched through SOAP.
• Your value as a future physician is not defined by one algorithmic outcome.

Practical steps:

• Keep in regular contact with at least one supportive friend or family member during Match Week.
• Use your school’s counseling or mental health services if feelings of hopelessness, shame, or anxiety become overwhelming.
• Set boundaries: Take brief walks, eat regular meals, and get sleep when you can. You will think more clearly and interview better if you are not completely depleted.

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Learning from SOAP Success Stories: Realistic Pathways to Residency

Listening to others who successfully navigated SOAP can help you reframe this experience as a detour, not a dead end.

Story 1: Strategic Pivot and Networking

A student initially applied only to a surgical subspecialty. They did not match, largely due to Step 1 scores below the field’s typical range and limited backup options.

During SOAP:

• Their dean helped them identify unfilled internal medicine programs in regions where the student had family ties.
• A previous IM attending, impressed with their work ethic, wrote a targeted email to several program directors as soon as those programs appeared on the unfilled list.
• The student highlighted their surgical sub-I experience as proof of resilience, work ethic, and comfort with acuity.

Outcome: They matched in SOAP to a solid community internal medicine program, later became chief resident, and are now pursuing a fellowship.

Story 2: Strengthening Narrative and Letters

Another applicant had average scores but inconsistent evaluations in early clinical years. They found themselves unmatched in their preferred field.

Their SOAP response:

• They worked with a faculty mentor to rewrite their personal statement, focusing on maturity, insight, and growth from early challenges.
• They added a new letter from a recent sub-internship where they had excelled, emphasizing improved reliability and communication.
• In SOAP interviews, they openly acknowledged their early struggles and highlighted concrete steps they took to improve.

Outcome: Programs appreciated the applicant’s honesty and trajectory. They matched into a categorical residency through SOAP and received positive feedback in subsequent evaluations.

These stories highlight the key themes of SOAP success: strategic flexibility, realistic self-assessment, active mentorship, and a growth-focused narrative.

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SOAP FAQ: Common Questions from Unmatched Residency Applicants

1. What exactly is SOAP, and how is it different from the regular Match?

SOAP (Supplemental Offer and Acceptance Program) is an NRMP-managed process that occurs during Match Week to fill unfilled residency positions with unmatched or partially matched applicants.

Key differences from the main Match:

• Timing: SOAP happens after the main rank-order list Match is complete.
• Mechanism: Instead of ranking lists, programs review applications and extend offers in multiple rounds. Applicants may accept only one offer.
• Eligibility: Only SOAP-eligible applicants (unmatched/partially matched and registered for the Match) can participate.
• Communication rules: There are strict limits on when and how you and programs can communicate during SOAP.

2. How many programs can I apply to during SOAP, and should I apply to all of them?

ERAS typically limits the total number of applications you can submit during SOAP (the exact number can vary by year). Because of this cap, applying to every single unfilled program is not advisable.

Instead:

• Prioritize programs and specialties that realistically fit your profile.
• Use your advisors and deans to help target your applications.
• Remember that quality and fit matter more than sheer quantity, especially when your time, attention, and interviews are limited.

3. What should I emphasize in my SOAP personal statement?

Your SOAP personal statement should:

• Clearly convey why you are suited for that specific specialty and how your prior experiences support this.
• Highlight core residency attributes:
  • Reliability
  • Teamwork
  • Work ethic
  • Empathy and communication
• If you changed specialties, briefly and professionally explain the rationale for the shift, focusing on what you’ve learned and why the new field is a better fit.

Avoid extensive focus on the disappointment of not matching. Instead, emphasize resilience, self-awareness, and readiness to start residency now.

4. If I don’t get a SOAP offer, what are my options?

If SOAP ends and you remain unmatched, you still have several paths:

• Post-SOAP positions: Some programs continue to have unfilled spots and may recruit outside SOAP. After SOAP concludes, communication restrictions loosen, and you may contact programs directly.
• Research or clinical fellowships: Many unmatched graduates spend a year in research, quality improvement, or non-ACGME clinical roles to strengthen future applications.
• Another application cycle: With a careful plan, improved application materials, and additional experiences, many applicants match successfully the following year.
• Career counseling: Meet with your dean and mentors to reassess specialty choice, geographic strategy, and exam plans.

Not matching even after SOAP is difficult, but it is not the end of your medical career. Many physicians have successfully navigated this setback and gone on to fulfilling, impactful practices.

5. Is matching through SOAP considered “lesser” than matching in the main Match?

No. From the perspective of ACGME accreditation, licensure, and future employment, a residency position obtained through SOAP is equivalent to a position obtained in the main Match.

Program directors and future employers are much more concerned with:

• Your performance in residency
• Your clinical skills and professionalism
• Your letters of recommendation
• Your board certification status

Most attending physicians and colleagues will never know—or care—whether you matched during the main Match or via SOAP. What matters is what you do with the opportunity once you’re in training.

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By understanding the SOAP process, preparing strategically, staying flexible, and prioritizing your well-being, you can transform an unmatched status into a meaningful residency opportunity. SOAP is not a failure; it is another pathway into the profession you have worked so hard to join.