No match for you? SOAP offers last-minute options

Monday of Match Week can bring disappointing news for some medical students participating in the 2019 Main Residency Match. Hundreds of U.S. medical students will find out on that date 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 applicants in the Main Residency Match apply for and are offered positions that were not filled when the matching algorithm was initially processed. The Friday before Match Week all Main Residency Match applicants received an email notification of their SOAP eligibility. SOAP is a service of the National Resident Matching Program (NRMP). 

U.S. medical students must have their school clear their graduation qualifications. In 2019, SOAP runs from March 11-14. 

In 2018, two veterans of the Match process offered guidance for medical students who may have to enter SOAP. Here are some of the most relevant nuggets of advice.  

Should I SOAP into a specialty that’s not my first choice? 

Christopher Libby, MD, MPH, PGY-2, the University of Central Florida's North Florida Regional Medical Center, emergency medicine residency: As an applicant, you have to decide whether the specialty you aspired to match into is something you will try for again or whether you will be happy in something else as well. You can't begin to form a strategy if you don't answer that first. 

So, if you are at risk of not matching, ask yourself a couple of questions ... 

What is the weakness in my application? Most, not all, U.S. applicants who did not match have a weakness in their application. If it is a board score or some disciplinary action, then some competitive specialties may not be realistic, especially in the SOAP. 

Do a modified SWOT analysis. What are the strengths of practicing this specialty? What are the weaknesses that I would not enjoy ... [i.e.] what about this clinically would I not like? What are the opportunities available in the specialty that would appeal to what I liked about emergency medicine? What are the threats to the other aspects of my life based on this specialty? 

Do you plan to reapply to the specialty you didn't match in? If you are going to try for your specialty again, you may choose to do a prelim year and reapply or to delay graduation depending on what your weakness is. 

If I get an offer through SOAP, should I take it? 

Nicole Deiorio, MD, professor and associate dean, student affairs in undergraduate medical education at Virginia Commonwealth University:  I definitely recommend a student take the first offer they receive, rather than wait for the second round. 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 advisor. 

Key resources from the AMA 

FREIDA™, the AMA Residency & Fellowship Database® (registration required), enables unmatched students to research residencies from more than 11,000 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.  

In addition, the AMA provides resources  to help recent medical graduates obtain their medical licenses, study for licensure exams and support legislation to increase the number of graduate medical education positions.