NRMP SOAP: 5 Steps to improve your odds of success

Securing a position through the Supplemental Offer and Acceptance Program (SOAP) is difficult but there are steps that you can take to make yourself a more attractive candidate.

Step 1: Plan Ahead

The first step in improving your odds of success in the SOAP is to recognize if you’re at risk of going unmatched. You should consider yourself at risk if any of the following apply to you:

• You're applying only to a competitive specialty.

• You feel that you're not as competitive as other applicants.

• You received a small number of interviews.

• You have red flags in your residency application

Red flags include such issues as:

• Failed USMLE or COMLEX attempt

• Low USMLE or COMLEX score relative to mean for matched applicants in your chosen specialty

• Course or clerkship failure

• Negative feedback on your MSPE

• Professionalism concerns (academic misconduct, misdemeanor or felony history)

• Unexplained gaps in CV

Knowing that you’re at risk will allow you to prepare an effective plan in advance of Match week. This plan can then be executed if your worst fears are realized.

Step 2: Consider Your Plan

Once you’ve determined that you’re at risk of not matching, the next step is to consider your plan. If you don’t match into your chosen specialty, what will you do? Consider the following options:

• Will you apply to unfilled residency positions in only your chosen specialty?

During SOAP, you will be able to apply to a maximum of 45 residency programs. Some specialties have consistently high fill rates which means that there will likely be fewer than 45 programs to apply to if you’re seeking positions in these fields.

Ask yourself what you will do if there are only a few positions available in your chosen specialty. Will you only apply to these programs? Or will you also apply to programs in other specialties?

Review NRMP Match statistics from previous years to get an idea of what you’re likely to encounter with respect to different specialties. You can also read our post about SOAP results from the 2018 NRMP Match.

• Will you also apply to programs in other specialties?

This will require you to reflect on your past experiences with different specialties. Is there another specialty that you would enjoy? For example, if you fail to match into orthopedic surgery, can you see yourself in a career in general surgery? If that’s the case, you may wish to create a plan to apply for either categorical or preliminary surgery residency programs.

• Will geography limit where you can apply?

If you were limited geographically when you initially applied for residency, has your situation or perspective changed? Your answer to this important question will significantly influence your application strategy. Keep in mind that geographical preferences can take time to sort through, especially if loved ones are involved.

• Is the SOAP the best option for you?

For some applicants, there may be other options to consider. For example, should you extend your medical school education to perform additional rotations? Should you do a research fellowship to improve your chances of success when you reapply? Discuss your options with your mentor.

Step 3: Prepare Your Application Materials

Take the time to carefully analyze your documents to see if you can strengthen these components of your residency application.

• Personal Statement

The personal statement is one of the few components of the application that you have full control over, and a well-written and compelling statement can enhance your chances of securing interviews during SOAP.

To begin with, you must analyze your original statement. Don’t be afraid to seek the input of others. Was there something about the statement that may have limited you from securing interviews? If so, rewrite the statement.

If you’ll be applying to other specialties in SOAP, don’t expect to make a favorable impression by just making cosmetic changes to your original statement. Your statement must be specialty-specific, and it must clearly indicate to readers that you’re committed to this specialty.

• Letters of Recommendation

Take stock of your letters of recommendation to determine if one or more letters affected your chances of securing interviews. Among the common mistakes that we see is not submitting a letter written by a physician in your chosen specialty, submitting too few letters from physicians in your chosen specialty (specialties differ in how many letters they prefer), and submitting generic or brief letters of recommendation. A note to IMGs: U.S. residency programs prefer letters written by physicians who have supervised you during clinical experiences in the U.S.

Following this analysis of your letters of recommendation, you may decide to submit new ones to strengthen your overall application.

• USMLE or COMLEX Transcript

Be sure that your updated USMLE or COMLEX transcript will be available.

• Medical School Transcript

If new grades are available, ask your medical school to have an updated transcript uploaded into the system.

• MSPE Addendum

MSPEs for U.S. medical students are generally prepared at the end of the third year of medical school. Speak with school officials to see if an addendum can be added to describe your performance in the clerkships that you’ve taken since then.

Step 4: Prepare for Residency Interview

Don’t wait to begin your interview preparation until you submit your application for SOAP. Start early so that you can develop winning answers to high-yield questions. Remember that you should expect to be asked some uncomfortable questions like “Why do you think you didn’t match?” These are not easy questions to answer but rest assured that your answers will have significant bearing on your chances of receiving an offer from the program. Some questions to definitely prepare for:

• What specialty did you pursue in the Match?

• Why do you think you didn't match?

• What do you consider to be the weak points in your application?

• Can you tell me more about your [red flag]? (failed USMLE or COMLEX, low score, etc.)

• Why are you now considering our specialty?

• How can we be sure you’re committed to our specialty?

• Where do you see yourself in 10 years?

• What do you hope to do with your career in the field?

• Why are you interested in our program?

• Why are you interested in our geographic area?

• If you don’t match through the SOAP, what will you do?

Don’t forget to prepare some questions to ask your interviewers. Failure to ask questions may turn off some interviewers.

Step 5: Prepare to be Available During SOAP

SOAP will begin on Monday of Match week. Ideally, you should be free of other responsibilities so that you can apply on Monday and be ready to field any phone calls or emails from programs. Such communication may occur as early as Monday afternoon but can extend into Tuesday, Wednesday, and Thursday.

• Be sure to have your phone and computer fully charged (don’t forget to keep your charger with you).

• Station yourself somewhere you will have a strong signal so that you can make and receive phone calls/emails. A missed call or a delay in responding to an email can prove to be disastrous.

• Test your Skype connections as some programs will prefer to interview applicants via Skype rather than the phone. Local programs may even ask you to interview in person.

• During SOAP, have easy access to your interview outfit. You never know when a program director may contact you for an interview.

Above all, don’t break any rules established by the NRMP for applicants participating in SOAP. Chief among these rules is that you (or anyone acting on your behalf) are not permitted to contact any residency programs. Residency programs must initiate contact with you. Failure to adhere to these rules may result in an NRMP violation, making it harder for you to match in the future.

Best of luck in the SOAP!