Post Residency Match SOAP: Essential Terms

SOAP (Supplemental Offer and Acceptance Program)
SOAP is a process that takes place during Match Week and is managed by the National Resident Matching Program (NRMP). It provides unmatched or partially matched residency applicants with an organized way to apply for unfilled residency positions. Instead of reaching out to programs individually, eligible applicants must submit applications through the designated systems, and residency programs extend offers in a structured four-round process. The goal of SOAP is to fairly and efficiently fill open residency spots while ensuring applicants follow a standardized process.

NRMP (National Resident Matching Program)
The NRMP is the organization responsible for conducting the Main Residency Match and SOAP. It manages the matching process between residency applicants and programs, ensuring a fair system where both parties submit their preferences and a computer algorithm determines optimal matches. The NRMP enforces strict rules to maintain the integrity of the process and prevent unethical behavior, such as direct applicant-program communication before offers are made.

R3® System (Registration, Ranking, and Results System)
The R3 System is an online portal run by the NRMP where applicants, residency programs, and medical schools access match-related information. This system is where applicants check their Match status, view the List of Unfilled Programs if they are eligible for SOAP, submit applications, and receive offers. It is also where residency programs rank applicants and finalize their selection process during SOAP.

ERAS (Electronic Residency Application Service)
ERAS is the online system managed by the Association of American Medical Colleges (AAMC) where applicants submit their residency applications, including their personal statements, letters of recommendation, and CVs. During SOAP, ERAS is the primary platform used for submitting applications to most specialties. Each program specifies whether they accept applications through ERAS or another system.

ResidencyCAS
ResidencyCAS is a separate application service used exclusively for SOAP applications in the specialty of Obstetrics and Gynecology (OB-GYN). Unlike ERAS, which covers most specialties, OB-GYN residency programs participating in SOAP require applicants to use ResidencyCAS to submit their applications.

List of Unfilled Programs
The List of Unfilled Programs is an official document within the NRMP’s R3 System that shows all residency programs with available positions after the initial Match. Only SOAP-eligible applicants can access this list at the start of SOAP. The list updates throughout SOAP as programs fill positions. After SOAP concludes, the list expands to show all remaining unfilled programs, including those that were not initially participating in SOAP. At that point, all unmatched applicants can reach out to programs directly. Make sure to know if you qualify for a program before you apply

SOAP Eligibility
Applicants must meet strict eligibility criteria to participate in SOAP. First, they must be registered for the Main Residency Match. They also must be unmatched or only partially matched, meaning they may have secured a preliminary or transitional position but not a categorical residency spot. Additionally, they must be eligible to start graduate medical education (GME) on July 1 of the same year. Eligibility is verified by an applicant’s medical school for U.S. graduates and by the Educational Commission for Foreign Medical Graduates (ECFMG) for international medical graduates (IMGs). Applicants who do not meet these requirements cannot access SOAP and must wait until SOAP concludes to explore unfilled positions.

SOAP Offer Rounds
SOAP operates in a series of four offer rounds, each lasting two hours. Residency programs review applications and rank applicants in order of preference. The NRMP system then extends offers to applicants in rounds based on program preferences. In each round, applicants receive notifications if they have been offered a position. They must accept or decline offers within two hours. If they accept, they are immediately removed from further consideration for similar positions at other programs. If they decline or let an offer expire, they will not be offered the same position again in later rounds.

Application Limits
During SOAP, applicants can apply to a maximum of 45 residency programs. This limit applies separately to each application service, meaning an applicant could apply to 45 programs through ERAS and another 45 through ResidencyCAS if needed. Once an application is submitted, it cannot be withdrawn or changed. Applicants must be strategic in selecting programs, as all applications count toward the 45-program limit.

SOAP Communication Rules
SOAP has strict communication rules designed to maintain fairness. Applicants are prohibited from contacting residency programs on their own; they must wait for programs to initiate contact. Similarly, programs are not allowed to ask applicants whether they would accept an offer before making one. Any violation of these rules, such as applicants attempting to influence programs or programs pressuring applicants, may lead to an investigation by the NRMP. Applicants found guilty of violations can be disqualified from SOAP and barred from participating in future matches.

Match Participation Agreement
The Match Participation Agreement is a legally binding contract between residency applicants and the NRMP. This agreement states that once an applicant accepts a position during SOAP, they must honor that commitment. They cannot decline the position later in favor of another offer. If an applicant rejects or ignores an offer in a particular SOAP round, they will not receive another offer for that same position in later rounds. This agreement ensures a structured and fair selection process.

Post-SOAP Unfilled Programs
After SOAP concludes, the List of Unfilled Programs updates to include all remaining unfilled residency positions, including those from programs that did not participate in SOAP. At this point, unmatched applicants are allowed to contact programs directly to inquire about available positions. This is different from SOAP, where direct communication is not allowed until programs initiate contact. Programs continue updating the list as positions are filled, and applicants must act quickly to secure remaining spots.

Learn more with the 6-part series on the NRMP SOAP, where we break down every step of the process, from eligibility to final placements. Stay informed and maximize your chances of securing a residency position!

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