The Residency Match: ERAS, NRMP, and Everything MS4s Need to Know
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Progress Note Editorial
Evidence-based · For exam prep, not medical advice
update Updated October 2026
Date of last content change
Built by surgery and anesthesiology residents·Written for USMLE Step 1
Category
The Match (NRMP Main)
SOAP (Supplemental Offer and Acceptance Program)
Key differences
compare_arrowsThe main Match is a months-long process; SOAP is a 72-hour scramble during Match Week
compare_arrowsNRMP uses a Nobel-Prize-winning algorithm (Gale-Shapley) that favors applicants' preferences
compare_arrowsSOAP positions are typically less competitive specialties or programs that went unfilled
compare_arrowsApplicants cannot participate in both the main match and SOAP simultaneously — Match comes first
compare_arrowsRank your list by honest preference — the algorithm makes it impossible to strategize your way to a better outcome
error Common mistakes
× Ranking programs strategically rather than by true preference — the Gale-Shapley algorithm makes this actively harmful
× Not applying broadly enough — match rates drop significantly for applicants with fewer than 15–20 interviews
× Waiting too long to prepare ERAS application materials — personal statements and letters of recommendation take months
quiz Test yourself
Quick check
1. The NRMP Gale-Shapley algorithm is applicant-optimal, meaning:
Explanation. The Gale-Shapley algorithm is applicant-optimal — it produces the best possible outcome for applicants given their rank list. Ranking programs in true preference order is mathematically optimal; any 'strategic' ranking can only make your outcome equal or worse.
2. SOAP (Supplemental Offer and Acceptance Program) occurs:
Explanation. SOAP occurs during Match Week (the week before Match Day in March). On Monday, unmatched applicants learn they did not match and can begin applying to SOAP-eligible unfilled positions. Offers are made Wednesday; SOAP concludes before Match Day Friday.
Frequently asked questions
How does the NRMP algorithm actually work?expand_more
The NRMP uses the Gale-Shapley stable matching algorithm. It iteratively proposes applicants to their top-ranked program; programs tentatively hold their highest-ranked applicants and reject others. Rejected applicants are then proposed to their next choice. This continues until all proposals are resolved. The algorithm is applicant-optimal — ranking honestly always maximizes your outcome. There is no strategy that can improve your result over truthful ranking.
What is a competitive number of interviews for the match?expand_more
Match rate increases sharply up to ~12–15 interviews and plateaus around 15–20. Below 10 interviews, match rates drop significantly. Data from NRMP shows that with 10 interviews, about 85% of applicants match; with 15+, it exceeds 95%. These numbers vary significantly by specialty — what's 'competitive' in internal medicine differs from orthopedic surgery.
Can you withdraw your rank list after submitting it?expand_more
Yes, but only before the NRMP deadline. Once the rank list deadline passes (typically the last Wednesday of February), lists are certified and cannot be changed. Match results are binding — if you match to a program, you are legally and ethically obligated to accept. Reneging on a match can result in suspension from future NRMP participation.
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