If you’re a residency applicant participating in the Match, getting the bad news on Monday of Match Week that you have not matched is your worst fear. But not matching can happen to anyone. Just ask Victoria Gordon, DO, an emergency medicine intern at HCA Houston Healthcare, in Kingwood, Texas.
A graduate of the Kansas City University College of Osteopathic Medicine, Dr. Gordon had her heart set on orthopaedic surgery. In fact, ortho residencies took up all 11 spots on her rank-order list.
“I wish I had been more prepared for the possibility that it wouldn’t work out,” said Dr. Gordon, an AMA member.
Being equipped isn’t just about dealing with the emotional letdown, she noted. It’s also about taking the immediate, practical steps required to land the right residency spot starting in the summer. The biggest of these steps is applying through the Supplemental Offer and Acceptance Program (SOAP), a system for residency programs to fill unfilled positions with eligible unmatched or partially matched applicants during Match Week.
“It’s unfair and it sucks a lot of the joy out of your life, but essentially everyone who doesn’t match has to SOAP,” she said.
FREIDA™, the AMA Residency & Fellowship Database® (registration required), enables unmatched students to research residencies from more than 12,000 programs both during and following SOAP. Access is free, but extra benefits—such as a dashboard that helps users save, rank and keep notes on each program—are available to AMA members.
Preparation is everything
Those 24 hours after the initial Match email comes through are critical. Applicants find out if they matched at 9 a.m. EDT on Monday of Match Week, and SOAP-eligible unmatched and partially matched applicants can access the list of unfilled programs right away. The SOAP application form, MyERAS, opens an hour later, and applications are due by 9 a.m. EDT Thursday, although programs can begin reviewing applications as early as 8 a.m. EDT Tuesday.
When Dr. Gordon got the news that she hadn’t matched, she was hardly prepared.
“I had dyed half of my hair purple in the beginning of March. I thought: I'll never have to interview again for residency,” Dr. Gordon said. “Plus, I was sleeping on the floor of my friend's studio apartment—in another state—and I had no clothes. I felt like I was in an alternate universe.”
Still, she found a match. But it wasn’t easy. Following are her recommendations for navigating the SOAP process—even before it starts.
Put a team in place
“Make a plan with your classmates that if any of you have to SOAP, you’ll all work together to help them,” Dr. Gordon said. “The physical workload of revamping your application and trying to take all the interviews and answer all the calls and emails is too much for one person and one day. You need a group of people who are willing to come to you and help you through it. Manpower is most important.”
Watch this “AMA Moving Medicine” interview with AMA Chief Academic Officer Sanjay Desai, MD, for more great advice on what to do if you don’t match.
Know what you’re looking for
You might have your heart set on a particular specialty, but you should know which other residency programs work with your career goals and which ordinarily have SOAP spots available. Some specialties typically have very few spots available, even during Match.
Learn with the AMA about which specialties place the most residents through SOAP.
Have your assets ready
Preemptively write personal statements for the specialties you think you might SOAP into. As part of this, think about reaching out to relevant preceptors in advance for letters of recommendation, as well as tips on the buzzwords that residency programs look for.
“I learned that sometimes just one word can convince someone to give you an interview,” Dr. Gordon said. “For example, instead of ‘hard-working,’ people in a particular specialty might prefer ‘determined.’ You never know. So reach out to somehow who does know to help you curate your personal statement.”
Allow yourself time to mourn
“It's OK to feel your feelings about not matching, but you also have to set yourself a time limit, which sounds cruel, but you can’t sit there and cry all day—you have to revamp your applications,” Dr. Gordon said. “So, get up and feel your feelings, but set yourself a timer. Then sit down and start working.”
Be generous—and selective
“You only get 45 tokens, meaning you can apply to a maximum of 45 residency programs,” Dr. Gordon said, noting that the NRMP website has detailed information on how the process works. “If none of those programs gives you an interview, you can't go back and reuse your tokens. So, use them all, but don’t waste them.”
Learn how the AMA has updated its comprehensive policy on reforming the National Resident Matching Program.
