No match for you? SOAP offers last-minute options

Brendan Murphy
Staff Writer
AMA Wire
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Monday of Match Week can bring disappointing news for some medical students participating in the 2018 Main Residency Match. Hundreds of U.S. medical students will find out today 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. This past 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. The NRMP  website offers resources detailing SOAP, which ends Thursday, March 15.

A recent discussion in the AMA’s Succeeding in Medical School Community touched on applicants’ options if they do not match. Here is a look at some key questions about SOAP and relevant advice from the experts.

Should I SOAP into specialty not my first choice?

Christopher Libby, MD, MPH, PGY-1, 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 of emergency medicine and assistant dean for student affairs and colleges at Oregon Health & Science 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, although this should be discussed on a case-by-case basis with an advisor.

Key resources from the AMA

The AMA Residency & Fellowship Database® (registration required), also known as FREIDA Online®, enables unmatched students to research residencies from more than 10,000 programs both during and following SOAP. Access is free, but extra benefits 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.

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Jun 14, 2018
New med students have low distress levels, but that changes quickly and can worsen in residency and in practice. The AMA is pushing initiatives to help improve well-being at all levels.