Supplemental Offer and Acceptance Program Outcomes in a Family Medicine Residency Network

The National Resident Matching Program's (NRMP) Supplemental Offer and Acceptance Program (SOAP) places unmatched applicants in residency programs. We examined the outcomes and experience of family medicine residency programs that matched with residents through SOAP.

In 2020, all program directors in a regional family medicine residency network whose programs had participated in SOAP (n=23) completed a survey on their experience with SOAP and characteristics of residents who were matched via SOAP (n=52) anytime between 2012 and 2020. Resident outcome measures included graduation, remediation, leadership, fit, and comparisons of Milestones areas. Experiences with the SOAP process included factors that may have led the program to SOAP and advice for other programs participating.

Eighty-seven percent of residents matched via the SOAP graduated, and the majority compared favorably to other residents. Two-thirds of program directors were very likely to hire their residents matched via the SOAP. Rural programs had similar outcomes, although rural-track positions represented 30% of all residents matched via the SOAP in the study. More than half of all responding program directors reported being underprepared for the SOAP process. Program directors recommend getting familiar with the NRMP resources and setting aside time for key personnel in case a program needs to participate in SOAP.

The vast majority of residents matched via the SOAP are well prepared for training, contribute to their programs, and perform as well as other residents. Rural programs are more likely to place residents via SOAP than nonrural programs.