SOAP is an acronym for Supplemental Offer and Acceptance Program. It is a program that allows an applicant to be matched for a vacant residency slot if the student had not matched or was partially matched. Students are required to include their information and preferences in the Electronic Residency Application Service (ERAS) as part of the application process; then the directors of programs can browse through the ERAS data to select applicants. The SOAP just like the NRMP has shown favoritism to US applicants compared to FMGs. There is a limitation with regards to acceptance of FMGs into residency programs within the US. The principal reason is the prevention of mass migration from third world countries. It is believed that graduates of Medical schools in the US are better off academically and professionally than medical graduates from the third world countries. As such, to enhance their chance of gaining acceptance, one must graduate from a medical institution in the US or Canada.
About 25% of the healthcare professionals in the United States are made up of FMGs. For an FMG to be eligible to practice, he or she must present proof of credentials. FMGs face more significant challenges, much higher than those faced by graduates from United States medical institutions. An example of such a difficulty is the need for higher USMLE Step scores. Typically, successful candidates often emerge as the best and brightest among FMGs and are always thriving academically.
The original purpose for creating the NRMP is to ensure a seamless matching of students within the medical field to graduate programs. Before the medical graduates are can practice, they must complete a residency program and obtain a license. The NRMP serves to prevent unfairness during recruitment. Accordingly, the graduate program can focus more on the credentials of the applicants. Informal relationships and communication between applicants and senior personnel of graduate medical programs have been limited by the NRMP.