The Supplemental Offer and Acceptance Program, widely known by its acronym SOAP, is managed by the National Resident Matching Program (NRMP) and occurs immediately after the main Match algorithm concludes. SOAP’s purpose is to fill the residency positions that remain vacant after the primary matching process, offering a pathway for eligible medical school graduates who did not secure a residency spot. This formalized system replaces the previous chaotic “Scramble” by providing a rapid sequence for applicants to apply to unfilled programs. The entire process is time-sensitive and moves at an accelerated pace across just a few days of Match Week.
Applicant Eligibility and Timing
Participation in SOAP is limited to applicants who meet specific criteria established by the NRMP. Applicants must be registered for the Main Residency Match and have completed the rank order list submission, even if they ultimately failed to match to a program on that list. The fundamental requirement is that the applicant must be either completely unmatched or only partially matched to a residency position when the initial Match results are released.
The NRMP must also verify that the applicant meets all requirements to enter graduate medical education by the start date of the residency year, typically July 1. This verification is handled by the applicant’s medical school for U.S. graduates or by the Educational Commission for Foreign Medical Graduates (ECFMG) for international medical graduates. SOAP begins on the Monday of Match Week, the same day applicants find out their initial match status, and lasts through Thursday.
Accessing Available Positions
Eligible applicants access the list of open residency spots through the NRMP’s Registration, Ranking, and Results (R3) system. This List of Unfilled Programs (LUP) is the definitive source, showing only the positions for which an applicant is eligible based on their match status and other criteria. The LUP is made available on Monday of Match Week, and applicants must use the Electronic Residency Application Service (ERAS) to submit their application materials to the programs listed.
Programs participating in SOAP use their designated application service, such as ERAS, to collect and review applications from the pool of unmatched candidates. Applicants are limited to submitting a maximum of 45 applications for the entire SOAP process, a constraint that requires strategic decision-making. This application limit includes any programs they may have applied to during the regular season if those programs are now on the LUP.
Programs begin reviewing applications on Tuesday morning and may contact candidates for interviews, which are typically conducted virtually and scheduled very quickly. Throughout this period, applicants must avoid any contact with programs outside of the official communication channels, maintaining the strict integrity of the process.
The Offer and Acceptance Sequence
The core of the SOAP process is a series of strictly timed offer rounds that take place over Wednesday and Thursday of Match Week. Offers are extended directly by programs to selected applicants via the NRMP’s R3 system, rather than through a second matching algorithm. Programs create a preference list of applicants they wish to offer positions to, and the R3 system sends out offers sequentially according to these lists and the number of remaining vacancies.
There are typically four distinct offer rounds, each lasting exactly two hours. For example, a round might start at 9:00 a.m. Eastern Time and conclude at 11:00 a.m. ET, followed by the next round beginning at 12:00 p.m. ET. An applicant who receives an offer must accept or reject it within this two-hour window through the R3 system interface.
If an offer is accepted, the applicant is immediately removed from the SOAP pool, and the commitment becomes binding under the Match Participation Agreement. Rejecting an offer or allowing it to expire means the applicant remains eligible for subsequent rounds. Applicants and their representatives are strictly prohibited from contacting programs to discuss offers or applications outside of the R3 system until SOAP officially concludes.
Next Steps for Unmatched Applicants
For applicants who remain unmatched after the final SOAP round concludes, the formal NRMP process ends, but the search for a position continues. After the SOAP timeline finishes, the NRMP releases an updated List of Unfilled Programs, which includes all remaining vacancies, even those from programs that did not participate in SOAP. At this point, the rules change, and applicants are free to contact programs directly, often referred to as the “post-SOAP scramble.”
This phase requires swift and proactive effort, with applicants reaching out to program directors and coordinators via email with updated application materials. If a residency position is still not secured, applicants must pivot to long-term strategies to strengthen their candidacy for the next Match cycle.
Strategies for Reapplication
Options include:
- Pursuing research fellowships or clinical observerships.
- Securing a transitional year or preliminary position to gain additional clinical experience.
- Working with a medical school advisor or a career counselor to identify weaknesses in their previous application.
- Developing a targeted plan for improvement, such as enhancing board scores or acquiring more letters of recommendation.
Securing a one-year preliminary residency position provides valuable experience while the applicant prepares to reapply to categorical programs the following year. The goal is to build a stronger profile to maximize the chance of matching successfully in the next cycle.