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A different perspective of the SOAP

Tanakorn Kittisarapong, MD
Education
May 31, 2017
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The Match. The happiest time of any medical student’s life. Years of hard work culminating into one moment of affirmation. It’s enough to bring any student, proud family and friends to tears. That is unless you find the daunting words pictured below:

Match Results: We are sorry, you did not match to any position.

Though I wish and hope that no one else has to see this screen, reality is in 2016 there were 1,130 unmatched post graduate year 1 (PGY-1) seniors of U.S. allopathic medical cchools. 8,640 unmatched PGY-1s total. I am one of those 1,130 unmatched PGY-1 from 2016, and I wish to share my experience during the Supplemental Offer and Acceptance Program (SOAP) so that others may not feel so ashamed or alone.

For those of you who are not familiar with the process of matching into residency, the SOAP is the next step for those prospective seniors who don’t match through the initial process.

The SOAP process used to be known as the notorious “scramble,” but that name used to stress people out. It was before the National Resident Matching Program (NRMP) organizing the process to its current state.

When it used to be the “scramble,” those who didn’t match would go to their schools’ academic offices sad and ashamed, get a list of programs with openings from their deans or other academic officials. Then a grueling process of calling each one of those programs in hopes to get a quick five-minute phone interview.

What happens during the SOAP now?

Those who didn’t match go to their schools’ academic offices sad and ashamed, get a list of programs with openings from their deans or other academic officials. Then there’s a grueling process of applying online through NRMP to each one of those programs in hopes to get a quick five-minute phone interview. As you can see, many things in the process have stayed the same with some added convenience.

And so begins my SOAP experience:

Several program applications later, I get a call from a program who after the phone interview said that they were extremely interested in me and hopefully we would get to see each other ” … if the stars align.” Yes, that is a direct quote.

Round 1 ends, and I see the dreaded message below.

All offers have been generated for the current round.

You do not have any offers for the current offer round.

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I apply to a few more programs in an anxious state, but within 20 minutes of the first round ending, I get a call from the same program, from another vice director I had not spoken to before who states again,”We are highly placing you so please don’t give up hope.”

I really wanted to go to this program as it was close to home and had ideals that fit perfectly with mine. It was the perfect institution to spend the next few years of my training. I decided to hold out another round with hope. It seemed to me that they were just as interested in me as I was in them.

Round 2 ends, and I see the same message:

You have no offers.

By the end of this SOAP process I am left heartbroken and jaded. No offers.

Why would you call someone to say they are “highly considering” you and then not offer them a position? Is it not too cruel to tell someone to have hope and keep themselves available because you are placing them “highly?” What if I did have other offers in round 1? What if I rejected those offers because I truly believed I would match with this program calling me with interest. I would be stranded. Matchless, just because a program director was too nervous to only call the people they were making offers to.

It is already bad enough to continue to give someone hope only to cruelly pull it away with each passing moment, but why would you also potentially convince them to make a decision that could ruin their entire career? Please remember that this is what we are paying for with med school. In the regular job market, some companies will pay applicants to come interview and only reach out to those whom they know they can extend an offer. The match doesn’t provide that same respect.

I hope that this article brings a different perspective to the stressed out medical system that is facing a shortage of what the AAMC predicts will range from 61,700 and 94,700 physicians in the United States. Such treatment will drive your much needed future physicians away. It will make them look for work in other industries who treat their prospective employees with more respect. The medical field already faces high rates of physician burnout and part of that is this sort of treatment. I want others who may have faced this same treatment not to feel so alone. I want the medical community and society as a whole to see what this process is like on the other side.

Medical programs are under stress to fill their residency positions. And due to the ranking nature of the system, there is a desire to call as many potential residents to fill those spots, but there are consequences for such actions. We are people, too. We are more than just a number.

Tanakorn Kittisarapong is a physician.

Image credit: Shutterstock.com

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