Sigh. Another one sided view from KevinMD.
Summary: She ended up in SOAP, and complains that she only had 2 hours to make a life-changing decision.
It appears she probably applied to Plastics. All of her research pubs are in that. If so, then everyone who applies in Plastics needs to know that there's a risk of not matching. This is not unexpected, and having a back up plan is key.
Some of her concerns are certainly valid. SOAP sucks, no question about that -- but it's loads better than the scramble that came before it.
"2 hours to make a choice" - this isn't really the case. You find out on Monday that you didn't match, and then interview at programs during the week. You know well ahead of the actual SOAP rounds which programs you have a chance at, and can review those programs and make a decision about what you want to do. SOAP applicants should already know, of all of the places they interviewed, which one they would pick if offered a spot. And the advice she received to take something in the first round where you get an offer is highly valid -- waiting for a "better offer" in a later round is almost certainly a disaster. This is why we have a match in the first place.
I entered SOAP, the Supplemental Offer and Acceptance Program—advertised as a second chance, but in reality, it feels more like a pressure cooker. Within hours, unmatched students are expected to gather new letters of recommendation, draft new personal statements, and apply to programs they haven’t visited in specialties they likely never considered
It is a pressure cooker, that's unavoidable. But anyone applying in plastics should have thought this through beforehand. And you don't really need new LOR's -- looking at your app it will be clear what specialty you initially applied for, LOR's from that specialty are probably fine (although better to have specialty specific LOR's if possible). And a new PS isn't really needed for the same reason.
In theory, SOAP offers choice, but that choice is an illusion. Offers come in timed rounds, and because there is no guarantee you will receive another in the next round, applicants are often advised to accept whatever comes first—whether or not it is the right fit. Yes, I was “fortunate” to receive multiple offers during SOAP. But what does “fortunate” even mean when you have just two hours to make a life-altering decision? There is no time for second interviews or opportunities to speak with current residents. No ability to truly compare programs or specialties, or consider what is best for your future, your training, or your family.
Speaking with residents would need to be done before the offer rounds, and I expect many programs would be happy to set that up. Not sure how much second interviews would really help. Her "fortunate" multiple offers in a round equates to multiple other people not getting an offer at all (although those offers will flow to the other rounds).
What the NRMP does not tell you is that accepting that offer is not like accepting any other job. It is a binding legal contract
Wut? This is very clear in the match registration process, and I expect everyone knows.
We desperately need reform.
- The NRMP must build in real time for applicants to evaluate all offers.
- Programs must offer meaningful interviews—not just ten-minute introductions.
- The waiver and deferral process must be transparent, accessible, and realistic for those facing major life changes.
Applicants should have thought through their options long before the rounds happen. More time = more delays for people who don't get an offer in the first round, so there's some real harm here. How much time? Days? How would that work?
Given the timeframe, it would be very difficult to do full interview days. If that's really desired, we'd need a much longer period for SOAP. That means match day would happen before SOAP is done -- which is a reasonable choice, although (perhaps) makes it clear who has matched and who has not. But I think that's less of an issue now that match day ceremonies have changed.
The waiver process is actually all of those things. I have had several residents who have had a match waived or deferred (both those matching to our PGY-1 and residents matching to fellowships). The key is that the issue causing the request for the waiver must be new -- the fact that she doesn't want to move her child from her daycare (which I completely understand, getting a good daycare can be a nightmare) is not going to fly since that's obvious from accepting the position. There's nothing in her essay about why she wants a waiver -- other than she changed her mind. And deferrals are a huge pain for programs -- so some may be able to do so, and some may not.
