Monday of Match Week may bring disappointing news for some medical students participating in the 2026 Main Residency Match. A small percentage of residency applicants will find out on that date—March 16—that they did not match. While time and space are limited, there is hope for those students who do not match.
The Supplemental Offer and Acceptance Program (SOAP) is a vehicle through which eligible unmatched and partially matched applicants in the Main Residency Match apply for and are offered positions that were not filled when the matching algorithm was initially processed. On Monday morning of Match Week, all applicants learn whether, but not where, they matched. Match status notifications will be sent by email. To apply to an unfilled position through SOAP, applications are submitted through the Association of American Medical Colleges (AAMC) Electronic Residency Application Service (ERAS).
In 2026, SOAP runs March 16–19. There are four SOAP Offer Rounds. In each Offer Round, applicants have two hours to accept or reject offers in the system. Offers not accepted or rejected expire automatically.
FREIDA™, the AMA Residency & Fellowship Database®, enables unmatched students to research residencies from more than 13,000 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.
Veterans of the Match process offered guidance for medical students who may have to enter SOAP. Here are some of the most relevant suggestions that can help make the process as free of friction as possible.
Should I use SOAP to find a position in a specialty that’s not my first choice?
The most personal part of the SOAP process is determining if you are comfortable in another specialty. If the answer is no—though the availability of positions in SOAP varies widely by specialty—you are most likely going to be reapplying for positions the following year.
In the most competitive specialties, not Matching can be a reality check. According to findings presented in a National Resident Matching Program (NRMP) webinar on the 2025 SOAP process, highly competitive specialties such as orthopedic surgery are among the top preferences of unmatched applicants from U.S. MD-granting medical schools. Many of the most competitive specialties, however, fill all their available positions in the main residency match. In 2025 that was the case for orthopedic surgery.
For some applicants, there may be a desire to reapply for a position in their preferred specialty the following year. But your prospects of matching as a reapplicant in a competitive specialty can be low.
In 2025, only 43 out of more than 929 orthopaedic surgery positions were filled by applicants who graduated from a U.S. MD-granting medical school a year prior to 2025—the category in which applicants who are reapplying to the Match most likely fall. Those figures indicate that if you don’t Match in orthopedic surgery the first time, your chances of doing so later are very slim.
Victoria Gordon, DO, had her heart set on orthopaedic surgery as an applicant in the 2022 Match. When she found out she didn’t match, Dr. Gordon considered a pivot to emergency medicine. Using her recent clinical experience, self-reflection and advice from others to guide her decisions, she pursued the specialty through SOAP.
“You have to pick a path and go down, and you can't pick multiple paths. There's not enough time,” said Dr. Gordon, who is currently pursuing a medical education fellowship after completing her emergency medicine residency. “Trust yourself. You prepared hard the first time. You'll do fine the second time.”
If you are certain you want to reapply to the specialty in which you did not match, medical students might want to pursue a preliminary residency position. If you decide to reapply, you’ll need to find ways to strengthen your applicant profile.
How can you strengthen your application for SOAP?
If you didn’t match, there’s likely one or two major reasons behind the result, such as low board scores or applying to a specialty that didn’t align with your level of competitiveness.
If you are at risk of not matching, you will need to reassess your application. One method is to do a modified SWOT (strengths, weaknesses, opportunities, threats) analysis of your application. It’s also vitally important to consult your mentors and medical school support staff as you prepare to modify your application.
When it comes to reframing your application and personal statement, the institutions to which you are applying understand the circumstances.
“Program directors are aware how scared and how unprepared you are,” Dr. Gordon said. “Frankly, they are upset they haven't filled. So, they're on a different side of the coin, but same problem.”
Dr. Gordon recommend SOAP applicants try to avoid reinventing the wheel if possible. For instance, she took the why—the reasons you are pursuing a career in medicine and in a given specialty—portion of her personal statement and retrofitted it for emergency medicine.
How should you decide where to apply?
While acting quickly is key, Dr. Gordon said you should still consider your personal preferences where you can.
“SOAP applicants are given 45 tokens,” Dr. Gordon said during a recording “Meet Your Match” series, as part of the “AMA Making the Rounds” podcast. “You might as well put all your chances out there.”
“I didn't apply anywhere I didn't want to live because if I was going to be changing specialties and changing my life, I wanted to have at least a benefit in location or type of program.”
If I get an offer through SOAP, should I take it?
In 2025, the NRMP webinar indicated that more than half of positions filled through SOAP were accepted in the first round of offers, and after the second round of offers, nearly 80% were filled. If you decline an offer in hopes of getting a better opportunity in a subsequent round, your chances of going unmatched increase substantially.
“I definitely recommend a student take the first offer they receive, rather than wait for the second round of SOAP,” said Nicole Deiorio, MD, a medical school professor and associate dean. “The availability of openings goes down dramatically for the second round, so it doesn't make [strategic] sense to “hold out for something better.”
“In general, I also recommend applicants use all 45 applications in the first round [of SOAP], although this should be discussed on a case-by-case basis with an adviser.”
Applicants should take some solace in this bit of good news: SOAP works. At the conclusion of SOAP in 2025, the active applicant placement rate for senior graduates of U.S. MD- and DO-granting medical schools was around 98%.
