The National Residency Match Program (NRMP) and the American Association of Medical Colleges (AAMC) has announced changes in the Scramble process to begin in the Residency Match year of 2012. After a few years of struggling with difficulties with the Scramble and deciding that the process was less effective than in past match years, a new process for finding positions following The Match is being developed. The new process will be launched as the Supplemental Offer and Acceptance Program (SOAP) in response to observations that the system in place was no longer able to adequately handle the large number of students attempting to match into the increasingly small number of residency positions following the Main Match.

The way Scramble is currently structured, the few positions that are available after the first 48 hours are very difficult to secure. This is due to the data overload on communications systems and residency programs being overwhelmed with applications during the Scramble process. To understand the amount of data transmitted by email, ERAS, and fax, let’s look at some numbers. Last year, there was an average of 439 applications sent per unfilled position in Family Medicine using ERAS – each needing all of the material to complete an application – usually 20-30 pages of material. However, this does not account for all of the 13,000 applicants that did not use ERAS to send their materials to apply for an unfilled position.

Originally, students would find out they did not match on Monday and then begin on Tuesday at noon eastern time to “scramble” to find a position after the NRMP posted the List of Unfilled Programs to its website. In the past, this consisted of feverishly calling, emailing, faxing and sending student ERAS applications in an attempt to reach programs and have a conversation with a program director to discuss placement into an open position. This has become increasingly difficult in the past 3-4 years of the match. If a student does not find a match on the first day, it is much less likely that the student will find a match on the following days and the search will continue until noon on Thursday, when U.S. medical schools hold their Match Day ceremonies. Unfortunately, in recent years many students found clogged information systems and residency programs wanting time to review the numerous applications and make decisions after the NRMP Scramble had concluded.

Despite several attempts by the NRMP, along with ERAS, to find solutions to help the process run more efficiently, the conclusion after these attempts resulted in a major overhaul of the entire process. To “clean up" the issues, the NRMP has introduced new procedures, aptly called SOAP or the Supplemental Offer and Acceptance Program.

The new SOAP Program will make the following changes in the current “Scramble” match system.

The NRMP will now take stewardship of the SOAP process which will improve the integrity, transparency and organization of the process. To ensure more integrity is afforded to SOAP compared to the Scramble, SOAP will also be covered by the Match Participation Agreement, and applicant and program participants will be penalized for infractions.

• Unmatched applicants will be posted the same time and day as the unfilled programs. (In the Scramble system, students had to wait until the next day to see the list of unfilled programs and did not have adequate time to strategize before making application choices)
• Applicants and programs will be required to send and receive applications only through ERAS
  • NRMP-participating programs that fill positions during Match Week must do so only through the SOAP
  • New functionality will be added to the NRMP’s web-based system
  • Applicants must accept or reject their offer(s) within a specific timeframe
  • Offers made and accepted under SOAP will be binding under the Match Participation Agreement;
  • Prior to Match Week, the NRMP will require medical school deans to recertify the status of their senior students

The following principles will apply to ERAS users participating in SOAP during Match Week:

• Only applicants who are certified by the NRMP to participate in SOAP will be able to apply to NRMP unfilled programs using ERAS. Applicants who used ERAS during the regular season but did not participate in the NRMP may use ERAS during the SOAP period; however, they will have access only to programs that are not listed on the
• Applicants applying via ERAS will have a limited number of applications they may transmit free of charge
• Non-NRMP participating programs that do not have unfilled positions will be encouraged to update their status in ERAS to indicate that they are “no longer accepting (NLA) applications”.

For more information, go directly to the National Residency Match Program (NRMP) Website and read this PDF on the SOAP. The entire proposed SOAP schedule as compared to the current Scramble schedule is located at http://www.nrmp.org/soap.pdf