For eligible unmatched applicants to residency programs, the Supplemental Offer and Acceptance Program (SOAP) can be a chance to land a residency position that went unfilled.

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On the Friday before Match week, all Main Residency Match applicants receive an email notification of their SOAP eligibility. In 2020, SOAP will take place March 16–19.

SOAP is a service of the National Resident Matching Program (NRMP). Data obtained from the NRMP offers insight on which specialties offered positions and which applicant types found success through the SOAP process.

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 such as a dashboard that helps users save, rank and keep notes on each program—are available to AMA members.  

Learn how veterans of the Match recommend students approach SOAP.


Preliminary positions most common

According to the NRMP’s “Results and Data: 2019 Main Residency Match,” 589 programs participated in SOAP last year, offering more than 1,600 positions to unmatched applicants. Of those positions, more than half were one-year preliminary positions.

The preliminary specialties that filled the most unfilled residency slots through SOAP were:

  • Preliminary surgery—430
  • Preliminary medicine—105
  • Preliminary obstetrics and gynecology—7
  • Preliminary pediatrics—3

In addition to SOAP, 110 applicants matched into one-year transitional programs, which typically offer residents rotations in surgery and internal medicine specialties.

Applicants who matched into preliminary or transitional programs—through SOAP or the Main Residency Match—have either matched in postgraduate year 2 (PGY-2) positions this year or will have to re-enter the Match to do so the following year.

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Categorical positions in SOAP

Categorical positions—a full-length residency training position—didn’t make up the bulk of those filled through the SOAP process last year, but there were several hundred full-length training positions filled. The most common categorical specialties filled through SOAP were:

  • Family medicine—238
  • Internal medicine—176
  • Pediatrics—60
  • Pathology—21
  • Neurology—19

There were also a handful of primary care positions filled in primary care internal medicine and primary care pediatrics that begin in the PGY-1 year and provide the full training required for specialty board certification. Nine primary care positions were filled in medicine and one was filled in pediatrics.

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Read about the three things you should do if you don’t match after SOAP.

Applicant types

Most years, the applicant breakdown in SOAP leans heavily toward international medical graduates (IMGs); 2019 was no different. The most common applicant participant by type included:

  • Non-U.S. citizen IMGs—4,818
  • U.S. citizen IMGs—3,593
  • Senior students at U.S. allopathic medical schools—1,916
  • Senior students or previous graduates from U.S. osteopathic medical schools—1,173
  • Previous graduate of U.S. allopathic medical schools—961

In total, 1,310 positions were filled through SOAP. Of those positions, U.S. allopathic seniors accepted half of them, osteopathic medical school graduates accepted 27.9% and IMGs as a group accepted 17.5%.

During SOAP, offers are extended to students from participating programs in a series of rounds. In 2019, there were two SOAP rounds: in the first round, 942 positions were accepted, and in the second round, 368 positions accepted. The 2020 SOAP will have three rounds, as is typical.

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