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SOAPing Into a Competitive Residency Program

9 min


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The last thing on most students’ minds going through the SOAP is, “how do I match into a competitive program?” The truth is, most SOAPing medical students just hope they Match into a residency program at all. But, the best applicants make the most of this tough situation. Sometimes, these students end up Matching into great programs through the SOAP. 


If you are the first type of student, don’t sell yourself short. Don’t forget that many competitive applicants fail to match for any number of reasons. This may be you! Reasons for not Matching vary widely (e.g., a poorly-made Rank Order List, not submitting enough primary applications, etc.). Don’t forget… just because you didn’t Match, that doesn’t mean you can’t end up in a great residency program by SOAPing.



SOAPing Into a Residency Program


See my guide on understanding the Supplemental Offer and Acceptance Program (SOAP) process. The full timeline and details can be found on NRMP website. The NRMP has also published a 6-minute video describing the SOAP process, which can be found here.



Why Do People/Programs Have Unmatched Spots?


Here is an excerpt from my guide on understanding the SOAP


When a program or a medical student doesn’t match, it always raises the question, “why?” Often, there is no clear answer as to why a student didn’t match or why a program didn’t fill one of their spots, or the answer isn’t clear. Sometimes programs don’t match because they are bad or malignant, new, non-academic, overconfident in creating their match list, or in an undesirable specialty. Many times, however, a great program can have an unfilled spot due to no fault of their own, just like some phenomenal applicants can go unmatched without any red flags. For example, following reports about emergency medicine physician oversaturation before the 2022 NRMP Match, there were 219 (+7.5%) unfilled emergency medicine residency spots in 2022. Aside from high fill rates and match rates, the total number of residency spots has not matched the growth in the number of total applicants, increasing the likelihood of an applicant going partially matched or fully unmatched. 



Taking Advantage of Open Spots for SOAPing Into a Competitive Residency Program


Don’t forget that programs make mistakes too. Sometimes, a program will fail to rank applicants strategically or overestimate their competitiveness. Just like some applicants! While many of the best programs (e.g., Children’s Hospital of Philedephia) will almost certainly never need to SOAP, there are many, many competitive programs that won’t match their top applicants. Some of those programs won’t fill all of their spots. 


If you are SOAPing, keep an eye out for competitive residency programs on the R3 System, to which you will get access if you enter the SOAP. Some things to look out for:

  1. Top programs
  2. Programs where you interviewed
  3. Programs where you know someone


Keep on the lookout for prestigious or well-regarded programs when you look through R3, depending on your specialty. US News is a great resource for finding out program rankings within your particular specialty. Better yet, if you interviewed at a program that is now trying to SOAP an applicant, re-apply! They may have overlooked your application the first time. By interviewing at that program, you’ve already demonstrated your willingness to rank them. Lastly, if you know someone who can put in a good word for you at a program during the SOAP process, then use that connection. Anecdotally, it seems to be a well-known fact that having connections to a program will increase your chances of SOAPing into that program. Sometimes, it’s who you know.



Improving Your Application


There are many steps to improving your application. You can find my guide on preparing your application for SOAP here



Watch Out! Avoiding a Malignant Program


Sometimes, good programs have open spots. But sometimes, “good” programs don’t match applicants for a reason. If a program is malignant or takes advantage of its residents, then applicants won’t rank those programs and those programs might have open spots. Make sure you’re in the know by talking to current residents at that program and by reading about those programs on social media (e.g., Reddit). Look for news reports about those programs abusing their residents or support staff. Do the residents regularly break duty hours? Are residents leaving the program? Can the hospital hold on to nurses and support staff? Your life will be very difficult if you have to do blood draws overnight because the hospital won’t hire more phlebotomists. 


Remember… SOAP interviews are notoriously short, and they might ask you to commit to going there on the spot. You won’t have time to get a feel for the program after you’ve agreed to an interview. Prepare before your interview by applying to places that have proven they care about their residents. 


For more information about SOAP, please check out any of the following links.


–    NRMP and ERAS SOAP Guide for Applicants

–    ERAS Applicant Checklist for SOAP 

–    ERAS Applicant SOAP FAQs

–    Supplemental ERAS Application SOAP FAQs


If you are planning to apply for residency matching, and need some extra help choosing programs, editing your CV and personal statements, navigating ERAS, getting ready for your interviews, etc. Elite Medical Prep is here to help! For more information about our residency advising program, please feel free to schedule a consultation call here.

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