Avoiding SOAP

​​​ How SOAP Works - Information from NRMP

Nothing is more anxiety provoking than learning you haven’t matched into your preferred specialty choice. Read below to learn more about how to lower your chances of not matching into a program and going through SOAP.

It has been our experience, the students who end up in SOAP:

  • Had an overly optimistic assessment of their competitiveness.
  • Were unwilling to consider any other specialty but “X” and had no Plan B.
  • Did not apply to enough programs.
  • Did not rank enough programs.
  • Tried to match in a specialty that they were not competitive in.
  • Did not apply to residencies where they had a realistic chance to match.

Assess your relative competitiveness:

The National Resident Matching Program (NRMP) posts an evidence-based report that will help you assess your relative competitiveness for a given specialty: Charting Outcomes in the Match

Did you know?

  • “The probability of U.S. Seniors, matching to their preferred specialty was .75 in the highly competitive specialties and .94 for the other specialties, translating to odds of matching up 3.0 to 1 and 15.7 to 1, respectively;
  • For U.S. seniors who preferred the highly competitive specialties USMLE Step 2 scores were significant, but USMLE Step 1 scores were a better predictor of match success;
  • Neither the number of research experiences nor the number of publications was a significant predictor of match success for U.S. seniors who preferred either a highly competitive or other specialty;
  • Having another type of graduate degree was not a significant predictor of match success for any U.S. Seniors.”
  • According to recent data, MD graduates who re-enter the Match a year or more after graduation have less than a 50% chance of obtaining a position.

Identifying the most competitive disciplines:

  • Dermatology
  • Orthopedics
  • Otolaryngology
  • Ophthalmology​
  • Neurosurgery
  • Plastic Surgery
  • Radiation Oncology
  • Urology

The Importance of a Plan B

If you are applying in a highly competitive specialty, it’s important to develop a Plan B. In general, it's a good idea to have parallel plans and to dual apply in an alternative specialty to lower your chances of ending up in SOAP. This may be somewhat less necessary if your Step I score is at or above the average for your specialty AND you are at the top of your class in your clerkship grades. However, even in these situations, some of our students have not matched into one of their top choices.