SOAP

[KnightDoc]

As my focus shifts from getting accepted to choosing a medical school, I have started to focus more on outcomes. Not so much matching into prestigious programs or hyper-competitive specialties, but just avoiding SOAP, which by all accounts appears to be a nightmare for those forced into it.

While pretty much all MD programs seem to brag about match rates above the national average, is there an easy way to find out what match rates were pre-SOAP? Is this information schools won't want to share? Any guidance here would be greatly appreciated.

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[Moko]

As my focus shifts from getting accepted to choose a medical school, I have started to focus more on outcomes. Not so much matching into prestigious programs or hyper-competitive specialties, but just avoiding SOAP, which by all accounts appears to be a nightmare for those forced into it.

While pretty much all MD programs seem to brag about match rates above the national average, is there an easy way to find out what match rates were pre-SOAP? Is this information schools won't want to share? Any guidance here would be greatly appreciated.

Congratulations!

IMO, almost all students can avoid the SOAP if they apply to a reasonable list of residency programs in a less competitive specialty. The problem is that not all students are willing to do so as they may be dead set on a hypercompetitive specialty ("Ortho or bust"), a particular location, or matching to a regionally or nationally known university program despite being at/near the bottom of the class in terms of clerkship grades, research, ECs, etc. Students need to be realistic with their residency application. For some students with a particular goal in mind, not matching and then reapplying the next year (after a research year) is seen as a more preferable outcome than matching to, say, general surgery or god forbid internal medicine as a back-up.

If a school's match list contains many preliminary / transitional year placements with fewer PGY2 residency positions (Anesthesia, Psychiatry, etc.), that may be a sign of poor match outcomes. But really the only way to know is to ask the school or a knowledgeable student, and hope they spill the beans. As you can guess, not all schools are inclined to share their actual statistics. Just my thoughts.

 

[Moko]

Also, on the flip side, you will also hear many medical schools say that the majority of their students match to their top (or within their top 3) residency programs. This statistic is also misleading. A student will only rank programs that they got interviews at, so their rank list may not represent their true top choices.

As an example:
- At the start of the application cycle for residency, let's say that we have two students who both want to match at MGH or BWH. Their next choices are the main hospitals for JHU, NYU, and so on down the list according to USNWR rankings.
- Student A has a stellar application and received interviews at MGH, BWH, JHH, etc. Student B on the other hand has a mediocre application (still categorized as "excellent" on the MSPE) and received interviews at Columbia NYP (USNWR rank 11) and other programs down the list.
- When compiling their rank list, student A ranks MGH as their first choice, BWH as their second, etc, while student B ranks NYP as their first choice among the programs they interviewed at.
- Student A ends up matching at NYU (#4 on their rank list), while student B ends up matching at NYP (#1 on their rank list, but really their 11th choice).

Looking at this 'first choice' statistic, it would seem that student B came out ahead, even though from student B's perspective they ended up at a less desirable program than student A. So despite many schools having 90%+ 'first choice' matches, the true 'first choice' statistic is lower as not all students will interview at their true top choices.

As with any statistic, it needs to be interpreted with caution and the appropriate context.

 

[KnightDoc]

Also, on the flip side, you will also hear many medical schools say that the majority of their students match to their top (or within their top 3) residency programs. This statistic is also misleading. A student will only rank programs that they got interviews at, so their rank list may not represent their true top choices.

As an example:
- At the start of the application cycle for residency, let's say that we have two students who both want to match at MGH or BWH. Their next choices are the main hospitals for JHU, NYU, and so on down the list according to USNWR rankings.
- Student A has a stellar application and received interviews at MGH, BWH, JHH, etc. Student B on the other hand has a mediocre application (still categorized as "excellent" on the MSPE) and received interviews at Columbia NYP (USNWR rank 11) and other programs down the list.
- When compiling their rank list, student A ranks MGH as their first choice, BWH as their second, etc, while student B ranks NYP as their first choice among the programs they interviewed at.
- Student A ends up matching at NYU (#4 on their rank list), while student B ends up matching at NYP (#1 on their rank list, but really their 11th choice).

Looking at this 'first choice' statistic, it would seem that student B came out ahead, even though from student B's perspective they ended up at a less desirable program than student A. So despite many schools having 90%+ 'first choice' matches, the true 'first choice' statistic is lower as not all students will interview at their true top choices.

As with any statistic, it needs to be interpreted with caution and the appropriate context.

Thank you very, very much for the insight as I begin the next step in my journey! This is extremely helpful.

 

[LizzyM]

Bottom line: Don't blame the school for the number of students who SOAP, blame the students who have unrealistic aspirations or who are willing to go all in and take a chance of not getting anything.

SOAP: Supplemental Offer and Acceptance Program. Basically, notification early in the week that you did not match anywhere for residency (the residency programs you wanted to join all picked other applicants) and thus a scramble begins for schools with unmatched slots looking for prospective residents who did not match. This happens behind closed doors so that on match day you have an envelope to open with the rest of the class.

 

[Mr.Smile12]

This is why the relationship with your student dean who will know about your MSPE is critical. They should give you a very realistic view of where you should focus and whether to apply. Basically they are the med school version of prehealth advisors but have a lot more involvement with helping you succeed... at least that's my impression. Being humble is truly essential to avoiding the SOAP.

 

[TelemarketingEnigma]

I think one thing to look for when choosing a school is to make sure your school has as many home programs as possible for the specialties you might be interested in. My advising dean was great and could give general advice, but she wasn't in my specialty. So the most detailed advice I got on my application came from the PD and residents at my home program. for more competitive specialties, home programs will also mean greater access to research opportunities and ways to demonstrate interest.

 

[The Knife & Gun Club]

Yea from any USMD school any applicant should be able to match. And no SOAP numbers for med schools are not public and are never published - just the final match results (regular + soap).

You will not have any trouble matching from a USMD school, provided you apply smart and receive decent mentoring. My MSPE dean literally sat me and my wife down a month before couples match, ran our list with us, and pointed to different programs on our list. “This is unlikely but take your shot and put it #1.” “This program is your firewall - youre virtually guaranteed to match here so put it ahead of all your undesirable programs.” Etc. She predicted exactly what our final match location would be (pretty impressive for a couples match list with 400 combinations on it). As long as you listen to your mentors you will match.

Beyond that when picking a school just pick one that has an affiliated residency and teaching hospital. You need access to academic faculty in your desired field whatever it is.

 

[deleted771945]

Don't blame the school for the number of students who SOAP, blame the students who have unrealistic aspirations or who are willing to go all in and take a chance of not getting anything.

For those of us who are selecting medical schools right now, what can we blame the school for, in regards to outcomes?

 

[KnightDoc]

For those of us who are selecting medical schools right now, what can we blame the school for, in regards to outcomes?

BINGO!!! I was thinking exactly the same thing!!

I think the answer from the school's perspective is that any success is going to be due to the wonderful opportunities, education, guidance, mentoring, prestige, etc. that comes from an affiliation with the school, but that any failures are going to be totally on us. For not working hard enough, not being good enough, not recognizing our limitations, etc.

Maybe not so ironically, the higher up the rankings you go, the more this will be deemed to be true. Which then begs the question, so who needs the fancy schools? Stars are going to shine no matter where they go, and, if you can't match into a competitive specialty at a fancy institution coming out of a T10 school, it's sure as hell not the school's fault! 😎

Honestly, a lot of that is probably true, but it's still frustrating as hell that schools won't share pre-SOAP match rates. Whether it's because advising and mentoring sucks, or because a school has a disproportionate number of people who refuse to accept good guidance, or because the school just attracts a weak class, I'd really like to know what pre-SOAP numbers look like.

High post-SOAP match rates don't impress me for any US MD program, since we all know there are more residency slots than US MD candidates, so being able to just grab anything at the end, that nobody else wanted, so you are not unemployed after MS4, is not really the impressive metric schools make it out to be. (98.2% match rate!!! Only 2% of our class chose to do nothing and deal with explaining THAT to their parents, rather than take one of the really crappy remaining slots!!! 😎)

I'd really like to know what percent of a class gets its first choice, one of its first 10 choices, or any choice at all pre-SOAP. If this isn't an important reflection of how well a school prepares its students, then don't bother sharing MATCH data at all, since I already know that pretty much everyone matches SOMEWHERE, and that "better" schools have "better" students and will consequently have "better" matches.

 

[deleted314957]

As my focus shifts from getting accepted to choosing a medical school, I have started to focus more on outcomes. Not so much matching into prestigious programs or hyper-competitive specialties, but just avoiding SOAP, which by all accounts appears to be a nightmare for those forced into it.

While pretty much all MD programs seem to brag about match rates above the national average, is there an easy way to find out what match rates were pre-SOAP? Is this information schools won't want to share? Any guidance here would be greatly appreciated.

Not 100% certain but I believe those numbers can be inferred after the NRMP data comes out. At least, a number of folks on the path board have been touting it for years. And lately, many more unexpected “ prestigious “ places are not filling thru the match. This pendulum swings all the time. I have seen it since the early 70’s. Ortho was once for the class apes. Path was the path to riches. Derm was dull.
Anyone could do gen surg and then a CV or plastics add on was no problem. It is largely supply and demand AND payor policy.