IMG Strategy for the SOAP Week: Hour‑by‑Hour Survival Schedule

Most IMGs lose the SOAP in the first 48 hours because they treat it like a scramble, not a military operation.

You cannot “wing” SOAP week as an IMG. You need an hour‑by‑hour plan before the chaos starts, or you will freeze, click the wrong boxes, and waste your rare chances.

I am going to walk you from the Friday before Match Week through SOAP Thursday. Clock by clock. At each point: what should be open on your screen, what you should be doing with your hands, and what you should refuse to waste time on.

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Overview: What Your SOAP Week Actually Looks Like

First, anchor the week. Roughly (exact US times vary slightly year to year, always confirm with NRMP/ERAS):

SOAP Week Timeline Overview

Period	Event
Pre-Week - Fri	Finalize rank list & SOAP prep
Pre-Week - Sun	NRMP registration / tech check
Match Week - Mon 11 AM	Unmatched status released
Match Week - Mon 3-5 PM	SOAP-eligible list + preference entry
Match Week - Tue AM	Round 1 offers
Match Week - Wed AM	Round 2-3 offers
Match Week - Thu AM	Final round + post-SOAP scramble

You have three competing jobs this week:

1. Admin: Lists, spreadsheets, ERAS edits, document uploads.
2. Outreach & intel: Mentors, alumni, residents, program coordinators.
3. Execution: SOAP applications, accepting offers, fast decisions.

Most IMGs fail by mixing these in the same hour. You will not.

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T‑3 Days: Friday Before Match Week

Morning (8:00–12:00) – Build Your Command Center

At this point you should:

• Clear your schedule for Mon–Thu: no clinic, no shifts, no flights.
• Set up your physical workspace:
  • Laptop + external monitor if possible.
  • Headset that actually works.
  • Paper notebook + printed quick sheets (ERAS ID, NRMP ID, USMLE numbers).

Create your SOAP Master Spreadsheet with tabs:

• Programs (empty for now)
• Contacts
• Template messages (faculty, coordinators)
• Offer tracking

Sheet	Key Columns
Programs	Program Name, ACGME ID, State, Specialty
IMG-Friendly (Y/N), Visa, Notes
Contacts	Name, Role, Email, Phone, Program
Templates	Situation, Message Type, Status

Back up everything in cloud storage (Google Drive, OneDrive, Dropbox). People lose laptops in this week. I’ve seen it.

Afternoon (13:00–17:00) – Craft Your SOAP Versions

At this point you should have 3–4 versions of your personal statement and CV focus:

1. Core Internal Medicine / Family Medicine
2. Transitional / Preliminary Medicine
3. Preliminary Surgery (if realistically in play)
4. “Open to any clinical” version (for desperate last-day situations)

You are not rewriting your life story. You are shifting emphasis:

• Less “longitudinal community research,” more “I function on nights and manage cross‑cover.”
• More “I can start tomorrow with minimal hand‑holding.”

Prepare:

• A 2–3 sentence “SOAP elevator pitch”:
  • Who you are (IMG, graduation year).
  • USMLE scores / attempts clearly stated.
  • One line on clinical strengths.
  • One line on why you are applying to THIS specialty during SOAP.

Example:

I am an IMG (Class of 2021) with Step 1 pass, Step 2 CK 236, and recent US clinical experience in Internal Medicine. I handle high‑volume floor work and cross-cover calmly and communicate clearly with teams. I am seeking a categorical or preliminary IM position where I can contribute immediately and grow within a structured teaching program.

Evening (18:00–22:00) – People and Documents

At this point you should:

• Email your strongest US mentors:
  • Ask if they are willing to:
    • Take calls rapidly during SOAP.
    • Send targeted emails or make calls to programs after your SOAP applications go in.
• Verify all documents in ERAS:
  • Step scores uploaded and correctly assigned.
  • MSPE, transcripts, ECFMG status.
  • Visa documentation accessible.

Create a SOAP Contact Sheet:

• Your phone number and email on one line.
• WhatsApp / Telegram if relevant.
• Time zone in big letters.
• Share with mentors who might advocate for you.

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T‑1 Day: Sunday Before Match Week

Morning (9:00–12:00) – Systems Check and Time Zones

At this point you should:

• Confirm:
  • NRMP registration active.
  • ERAS login working.
  • Email filters off. Spam folder visible.
• Set all devices to U.S. Eastern Time or at least know the exact offset.

Program alarms:

• Monday 10:55, 14:45, 17:00 Eastern.
• Tuesday–Thursday 8:45 Eastern + each offer round time.

Afternoon (13:00–17:00) – Specialty & Geography Decisions

You cannot click every box. As an IMG, you must pre‑decide:

• Primary specialty target(s) for SOAP.
• Acceptable alternatives.
• States you will accept under any circumstances.
• States you will absolutely not accept (family, visa, finances).

Write these as hard rules, not vibes. For example:

• I will accept:
  • Any IM categorical in NY, NJ, PA, OH, MI, TX.
  • Any FM categorical in Midwest or South.
  • Prelim IM with strong chance of reapplying IM next cycle.
• I will NOT accept:
  • Non‑ACGME positions.
  • Research‑only positions.
  • Prelim Surgery in a malignant program just “to be in the US.”

This protects you from panic‑accepting something that traps you later.

Evening (18:00–22:00) – Scripts and Templates

At this point you should prepare:

• Email template to program coordinators:
  • Short, respectful, 5–7 lines.
• Email template to mentors with “Program X I applied to; could you support?”

Write 3 calling scripts:

1. To a program:

   • Who you are.
   • That you applied via SOAP.
   • One sentence on fit.
   • A calm closing line (no begging).

2. To a mentor:

   • Program name.
   • Why you are a good fit.
   • Specific ask: “If appropriate, would you be willing to email or call the PD?”

3. To your family:

   • A short explanation of SOAP so they stop calling you in the middle of offer rounds.

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Match Week Monday: The Shock Day

This day breaks people. As an IMG, your composure is a competitive advantage.

Typical SOAP Week Time Allocation

Category	Value
Admin & Lists	40
Program Outreach	25
Mentor Coordination	20
Actual Offers/Decisions	15

10:30–11:00 (Eastern) – Pre‑Email Calm

At this point you should:

• Have only three tabs open:
  • Email.
  • NRMP.
  • A blank Word/Google doc for notes.
• Close WhatsApp groups. Turn group notifications off.

11:00 – you get the “Did not match” or “Partially matched” notification. Take 5–10 minutes. Feel what you need to feel. Then move.

11:15–13:30 – Initial Reality Check & Gather Info

At this point you should:

1. Confirm your SOAP eligibility in NRMP.
2. Check exactly how many positions you are eligible to apply for.
3. Review your own file:
   • Any red flags? Gaps, attempts, older grad year?
   • This changes how aggressively you must apply to prelims vs categoricals.

You still do not know which programs are open. That comes at 15:00. So you use this block for:

• Short call with your main mentor:
  • Confirm target specialties.
  • Confirm whether they agree with your “hard rules” on offers.

Have lunch. Real food. You need your brain later.

14:30–15:00 – Logged In and Ready

At this point you should:

• Be logged into:
  • ERAS.
  • NRMP SOAP section.
• Have your spreadsheet open on the second screen.

Do not let anyone call you during the next 2 hours. Warn them in advance.

15:00–17:00 – Program List Release & First Filter Pass

NRMP releases the List of Unfilled Programs.

From 15:00–15:30:

• Export or copy the list.
• Filter by:
  • Specialty.
  • State.
  • “Sponsors visas” if indicated.
• Start populating your Programs tab in the spreadsheet quickly:
  • Program name.
  • Specialty.
  • State.
  • Visa friendliness (if known).
  • IMG‑friendly (from past research or online forums if you have it).

From 15:30–17:00:

At this point you should:

• Do a rapid triage pass:
  • Tier 1: Reasonable IMGs chances + good geography + visa support.
  • Tier 2: Less ideal location or unknown culture but still ACGME accredited.
  • Tier 3: Back‑up of back‑ups (only for use if your profile is weaker).

You are not deep‑researching. You are trying to get to a ranked list of 45–60 programs you would actually join.

17:00 – ERAS typically opens for applications / preference signaling for SOAP programs (check the year’s exact timing). Be ready, but do not panic‑click.

17:00–20:00 – First Wave of SOAP Applications

Remember you have a limited number of SOAP applications (usually 45). As an IMG, you cannot burn them on crazy reaches with no visa support.

At this point you should:

Hour 1 (17:00–18:00):

• Apply to:
  • Your Tier 1 list in your primary specialty.
  • A few balanced Tier 2 options in safe states.
• Customize personal statement minimally:
  • 1–2 lines for “why this region/program type” if time allows.
  • It is fine if 80–90% is generic as long as there are no obvious mismatches.

Hour 2 (18:00–19:00):

• Fill remaining slots with:
  • More Tier 2.
  • Select Tier 3 if your profile is weaker (low CK, multiple attempts, older grad).

Every 5–10 applications, pause and recheck:

• Are you tracking which program got which PS version?
• Did you accidentally apply to a non‑visa program if you need a visa? Fix it before you burn slots.

19:00–20:00:

• Double‑check assignment of:
  • LORs (ensure strongest US clinical letters are attached).
  • USMLE transcripts.
• Send brief, targeted emails to:
  • Programs where you have a real link (alumni, rotation, hometown).
  • Use your prewritten template, keep it under 8 lines.

Stop for the night by 21:00. You need sleep; Round 1 offers come early.

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Tuesday: Round 1 Offer Day

Exact offer times vary, but typically mid‑morning Eastern.

7:30–8:30 – Set Up for Offers

At this point you should:

• Be logged into NRMP SOAP.
• Have your Offer Decision Rules sheet ready:
  • Which specialties you will accept on the spot.
  • Which you need 10–15 minutes to think about.
• Rank your applied programs in 3 colors on your spreadsheet:
  • Green: Accept immediately if any offer.
  • Yellow: Accept if no green offers in that round.
  • Red: Only consider if desperation and no other options.

8:30–12:00 – Round 1 Offer Window

During the offer window, you must:

• Keep NRMP open and stable; do not refresh frantically.
• When an offer appears:
  • Immediately identify which color category it is.
  • If Green: Accept.
  • If Yellow: Take a few minutes but not the full window. Waiting for a “maybe” from a green that never comes can leave you with nothing.
• Document each offer and your decision in the spreadsheet.

You cannot negotiate or ask for more time. Declined offers return to the pool for later rounds.

Use the gaps:

• Send gentle updates to a mentor:
  • “I have applied to X, Y, Z; no offers yet this round.”
  • This keeps them primed to help in Round 2.

12:00–15:00 – Debrief and Recalibrate

If you have a position accepted: you are done with SOAP. Do not second‑guess.

If you still have no offers:

At this point you should:

• Re‑examine:
  • Are your target specialties too ambitious for your profile?
  • Do you need to expand geography or accept prelim years?

Use early afternoon to:

• Identify new programs that appear after other candidates accept offers (unfilled list can shift).
• Prepare to use remaining SOAP applications (if any left) in Round 2.

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Wednesday: Round 2 (and Often Round 3)

The emotional fatigue hits here. IMGs who planned their scripts and lists hold up better.

7:30–9:00 – Expand or Tighten Strategy

At this point you should make a clear choice:

• Strategy A (decent profile, 0 offers): Stay mostly with categorical IM/FM but open slightly more geography.
• Strategy B (weak profile, 0 offers): Aggressively add prelim IM or FM positions and less ideal locations.

Use this block to:

• Apply to newly unfilled programs if you have application slots left.
• Email your contacts with specific program names for targeted support.

9:00–12:00 – Round 2 Offer Period

Process is the same as Tuesday, but your thresholds change:

• Some “yellow” programs may become “green” now.
• A prelim IM in a solid teaching hospital is often better than reapplying from outside the system with no US experience.

I have watched IMGs refuse a decent prelim because they were “categorical or nothing,” then sit unmatched for years. Be realistic.

Between offer checks:

• Keep notes on which specialties and regions are actually sending offers to IMGs in your circles. That gives you intel for Round 3 and future cycles.

12:00–18:00 – Final SOAP Adjustments

If you still have no offers by mid‑afternoon Wednesday:

At this point you should:

• Accept that Thursday’s rounds will be chaotic.
• Widen your acceptable options slightly within ACGME‑accredited programs.
• Reach out to:
  • Your med school dean’s office.
  • Any alumni in your target specialties.
  • Residents you have worked with.

Ask them bluntly:

If you were me, with this profile, at this point in SOAP, what types of programs would you target?

Update your offer color coding once more for Thursday.

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Thursday: Final SOAP Rounds + Post‑SOAP Scramble

This is where people do reckless things. You will not.

7:30–9:00 – “Last Day” Ground Rules

At this point you should:

• Write down on paper:
  • Positions you will accept immediately.
  • Positions you will accept only if absolutely nothing else appears by the final round.
• Show this list to a trusted mentor if possible. Get a 2‑minute sanity check.

You must protect your future self. Accepting a toxic, non‑educational prelim with no chance of reapplying is often worse than not matching.

9:00–12:00 – Final Offer Rounds

Same mechanics as prior days, but:

• Move faster on yellow options; there may not be a next round.
• Do not chase “dream” programs that have shown zero interest.

You are managing risk now, not fantasy.

If you accept a position:

• Immediately:
  • Screenshot or download confirmation.
  • Email family and mentors with short update.
  • Log off NRMP. You are done.

12:00–16:00 – If You Are Still Unmatched

At this point, SOAP is concluding or over. Now you shift into post‑SOAP strategy, not more frantic SOAP clicking.

Your afternoon should be:

1. Document reality:

   • Where did you apply?
   • Which specialties?
   • Any interviews / calls / near offers?

2. Post‑SOAP “scramble” (very limited now, but still exists in some years):

   • Rare unfilled programs might accept direct outreach.
   • Only contact if you are a realistic candidate for that program.

3. Plan the next 6–12 months:

   • Research positions in your field.
   • Observerships / externships.
   • Retaking CK (if low) or adding Step 3.

Do not sign any non‑ACGME “residency‑like” position in desperation without having a mentor review it.

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Quick Reference: Hour‑by‑Hour Skeleton

Day	Morning Focus	Midday Focus	Afternoon/Evening Focus
Monday	Process shock, plan	Mentor call, strategy	Program triage + first apps
Tuesday	Offer rules, log in	Round 1 offers	Recalibrate & new apps
Wednesday	Strategy shift	Round 2 (and 3) offers	Expansion + mentor outreach
Thursday	Hard offer rules	Final offer rounds	Post-SOAP planning / scramble

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FAQ (Exactly 3 Questions)

1. How many SOAP applications should an IMG send to be competitive?

Use all of them, but intelligently. If you have 45 slots, most IMGs should aim for:

• 25–30 in their primary specialty (IM or FM for most),
• 10–15 in related or prelim positions,
• A few held in reserve on Monday evening in case new unfilled programs appear Tuesday.

Spraying 45 apps across six specialties usually backfires. You look unfocused and weak everywhere. Two, at most three, related specialties is the upper limit for a serious strategy.

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2. Should I call programs during SOAP or is that annoying?

Cold calling programs you have zero connection to, while coordinators are drowning in applications, is usually useless and sometimes irritating. What works better:

• Targeted emails to programs where:
  • You did a rotation.
  • You have a mentor, alumni, or resident connection.
• Having your mentor call or email on your behalf once your application is in.

If a program invites you to call or emails you first, respond quickly and professionally. But do not spend Tuesday and Wednesday randomly dialing numbers off the unfilled list.

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3. Is a prelim position worth it for an IMG or should I skip SOAP and reapply next year?

It depends on the quality and context of the prelim:

Worth considering:

• Prelim IM in a solid teaching hospital with a track record of helping prelims match categoricals.
• Programs where residents and alumni confirm they support reapplicants.

Usually not worth torpedoing your future for:

• Malignant surgery prelims with 80+ hour weeks and no educational support.
• Programs with historically poor board pass rates and no history of promoting prelims.

As an IMG, a good prelim can be a powerful bridge. A bad prelim can drain your time, energy, and exam performance and leave you right back in the SOAP next year. Get real intel before you click “accept.”

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Key Takeaways

• SOAP week is not about heroics. It is about executing a rigid, preplanned schedule under pressure.
• As an IMG, your edge is preparation: prewritten scripts, color‑coded offer rules, limited specialties, and realistic geography.
• The goal is not just “any job”; it is a survivable, accredited position that keeps your long‑term career alive.