Career·United States· 10 min read

The US Residency Match (NRMP) for International Medical Graduates: ERAS, SOAP and How It Works

How the US residency Match works for international medical graduates: registering with the NRMP, applying through ERAS, the rank order list, ECFMG verification, Match Day and the SOAP process for the unmatched.

Last updated 7 July 2026

Key facts

What it is: The NRMP "Match" pairs applicants with US residency programmes once a year via a preference-based algorithm
Two systems: Apply through ERAS (most specialties); register and rank through the NRMP R3 system
IMG requirement: Meet ECFMG Certification requirements by the rank-order-list certification deadline; status shows "Verified" after ECFMG confirms
Match timing: Match Week and Match Day fall in March each cycle
If unmatched: Eligible applicants may use the SOAP — no separate registration, no rank list
Dates & outcome data: Confirm the current calendar and IMG outcome data on the official NRMP and AAMC/ECFMG sites

The Match, in one picture

After ECFMG Certification, most international medical graduates (IMGs) enter US residency through the National Resident Matching Program (NRMP) — "the Match." It is a computerised system that pairs applicants with training programmes once a year using a mathematical algorithm, based on ranked preference lists submitted by both sides.

Two separate systems do two separate jobs. You apply to programmes through an application service (ERAS, run by the AAMC, for most specialties), and you register and rank programmes through the NRMP's R3 system. These are run by different organisations with separate registrations, so you must complete both.

The algorithm does not simply give programmes their top choices. It works in the applicant's favour, trying to place you into the most-preferred programme on your list that also ranks you — which is why an honest, preference-ordered rank list matters more than guessing what programmes want.

ERAS is where you apply to programmes; NRMP is where you register and rank
They are separate organisations with separate registrations — do both
The matching algorithm is applicant-preference oriented

Register with NRMP and apply through ERAS

You register for the Match directly with the NRMP through its R3 system, where you will later submit your rank order list and view results. You separately apply to programmes through ERAS, which most Match-participating specialties use (a small number use a different application service).

Once you complete NRMP registration, your NRMP ID is shared with the application service, linking the two records. Registration and application open on the official calendar each cycle, and there are firm deadlines — including a late-registration window — that you should confirm on the NRMP calendar for your Match year.

Treat the timeline as fixed and unforgiving. Missing a registration or rank-order deadline can cost you an entire year, so build your personal schedule backward from the official dates.

Register in the NRMP R3 system; apply to programmes through ERAS
Your NRMP ID links automatically to the application service after registration
Deadlines are firm — confirm the current cycle's dates on the NRMP calendar

ECFMG verification: the IMG-specific gate

For IMGs, the Match adds one crucial layer: you must have met the ECFMG Certification requirements — the medical science exams (Step 1 and Step 2 CK) plus the clinical and communication skills requirement — by the rank order list certification deadline to participate.

The NRMP and ECFMG exchange data regularly. ECFMG confirms whether each registered IMG has met the participation requirements, and your status in the R3 system changes from "Not Verified" to "Verified." If you are not verified in time, you cannot certify a rank list and cannot match.

Because verification depends on your exams and paperwork being complete and processed, work backward from the certification deadline. Leaving exams or credential verification to the last minute is the most common, and most avoidable, way IMGs lose a Match cycle.

IMGs must meet ECFMG requirements by the rank-order-list certification deadline
NRMP and ECFMG exchange data; your status moves "Not Verified" → "Verified"
Plan exams and credential verification well before the deadline

Interviews and the rank order list

Between application and the Match, programmes review applications and invite selected applicants to interview. After interviews, both you and the programmes submit rank order lists — you rank the programmes you would accept, in true order of preference, and programmes rank the applicants they want.

The golden rule is to rank programmes by your genuine preference, not by where you think you have the best odds. Because the algorithm favours the applicant, listing a less-likely-but-preferred programme above a safer one cannot hurt you at the safer one.

Rank every programme you would be willing to attend. Every programme you leave off is a place you cannot match to — for IMGs, casting a realistic but complete list is part of a sound strategy.

Programmes interview, then both sides submit rank order lists
Rank by true preference — the algorithm protects you
Include every programme you would genuinely accept

Match Day and the SOAP

Results are released during Match Week in March, culminating in Match Day when matched applicants learn where they will train. Applicants who do not match, or match to only part of a programme, may participate in the Supplemental Offer and Acceptance Program (SOAP).

SOAP is a structured process during Match Week in which eligible unmatched applicants apply to programmes that still have unfilled positions and may receive offers in timed rounds. There is no separate registration for SOAP and no rank order list — you apply to open positions and respond to offers as they come.

SOAP moves quickly and can be stressful. If you are eligible, prepare application materials in advance and be reachable throughout Match Week so you can act on offers without delay.

Match Week is in March, with results culminating on Match Day
Unmatched applicants may use SOAP for unfilled positions
SOAP has no separate registration and no rank list — act fast on offers

IMG realities and honest expectations

The Match is competitive, and outcomes vary by specialty, exam performance, US clinical experience, and how strategically an application is built. The NRMP and ECFMG publish outcome data for IMGs; read the official data rather than anecdotes when you gauge your competitiveness.

No one can guarantee a match. Programmes weigh many factors, and the same applicant can have very different odds across specialties. Build a balanced, well-researched list, and consider specialties and programmes that have historically been more open to IMGs alongside your top choices.

Most importantly, treat the Match, ECFMG Certification, and visa sponsorship as one connected plan. Many matched IMGs need a visa to train, and sorting sponsorship out early prevents a match you cannot take up.

Competitiveness depends on specialty, exams, US experience and strategy
No one can guarantee a match — rely on official outcome data, not anecdotes
Coordinate the Match with ECFMG Certification and visa sponsorship

Frequently asked questions

Do I register with NRMP and ERAS separately?

Yes. NRMP and the application service (ERAS for most specialties) are separate organisations with separate registrations. After you register with the NRMP, your NRMP ID is shared with the application service, but you must complete both.

Do I need ECFMG Certification before I can match?

You must meet the ECFMG Certification requirements — the science exams plus the clinical/communication skills requirement — by the rank-order-list certification deadline. ECFMG verifies this with the NRMP, changing your status to "Verified."

What is the SOAP?

The Supplemental Offer and Acceptance Program lets eligible unmatched or partially matched applicants apply to unfilled positions during Match Week and receive offers in rounds. There is no separate registration and no rank order list.

How should I order my rank list?

Rank programmes by your genuine preference, not by where you think you are most likely to match. The algorithm favours the applicant, so ranking a preferred programme above a safer one cannot hurt your chances at the safer one.

Can any service guarantee me a match?

No. No service or coach can guarantee a residency match — outcomes depend on specialty, exam performance, experience and strategy. Rely on the official NRMP and ECFMG outcome data to gauge realistic competitiveness.

Official sources

This guide explains the process and is for guidance only. Eligibility, dates, fees and rules change every year — always confirm the current details on the official site before you act.

Verified against: NRMP — International Medical Graduate; NRMP — Eligibility Requirements; AAMC — ERAS and SOAP Information.

Last verified: 7 July 2026.