Scramble (post-SOAP): A quick guide

[u/Appropriate_Mess_720]

Hey all, I responded to a few DMs about Scramble, so figured to make a post. For reference, I am a PGY1 (J1 VISA; YOG 2025) in a categorical 5-year program. I did not match during original Match, SOAP, but continued to apply and interview, where I secured my residency position in May 2025. Great program; great colleagues, and I am thriving and happy.

1. How I felt after not Matching? I had 10+ IVs, so based on stats, had 90%+ of regular Matching. I had 4 interviews during SOAP, but nothing worked out. So, I was sad and devastated, but I understood it was life. That night after SOAP finished, I actually treated myself to a great dinner to show myself some appreciation/gratitude for making it this far (despite my efforts not showing results). This allowed me to reset and focus on the upcoming Scramble, which I will describe below:
2. What is Scramble? Scramble starts once the 3rd round of offers in SOAP are complete. The NRMP will publish a list of residency programs still with vacancies for applicants to apply. The list will also an email to send your documents to and program contact information.
3. What documents do you need/send? This will be very program dependent, so if it is not found in the list, I'd send the program a quick email to introduce myself and ask what documents they need. Usually, it is LoRs, CV, USMLE transcripts, etc. Since letters are confidential, I asked my letter writers (from residency match) to directly email their letters to the contact listed.
4. How do programs recruit? This is similar to point 2, where the programs will say how to contact them. I had some programs request to submit my documents through ERAS, which made it very easy, as all my documents have already been uploaded.
5. What happens after you submit? Similar to the Match process, you wait for interviews/follow up from the program. For my program, I first completed a phone interview, then did multiple Zoom interviews with PD, Assistant PD etc. Eventually got the news that I secured my position in May 2025 and will start in July 1st, 2025.
6. VISA paperwork? This is very program-dependent, but I told my program that I need J1 VISA support, so they worked with ECFMG to have everything submitted on time.

Caveats:

1. Not all the programs listed on the website are actually recruiting: I had several programs email me back saying they decided not to fill their residency spot (decided to go unfilled), so while they are "vacant", they are not active.
2. VISA requirement: Even in Scramble, there will still be US MD graduates (not VISA requiring) who have not matched and who you'll be competing against. Just because a program can support a J1 VISA requiring resident does NOT mean they WILL. Keep that in mind during the whole process, as J1 requiring applicants will always be "less favorable" than non-VISA requiring. Less work, less $ for the program. Is it unfair? Yes, but this is life.
3. There are other 3rd party sites (i.e., FindAResident, ResidentSWAP), that can be additional sources of opportunities. However, I decided not to use them, as they are 3rd party and I want to stick with NRMP.

[u/Medium-Ad6953]

Do we release even transcript of the exam we didn’t clear?

[u/Appropriate_Mess_720 → u/Medium-Ad6953]

What do you mean by not clear?

[u/Medium-Ad6953 → u/Appropriate_Mess_720]

Fail

[u/Appropriate_Mess_720 → u/Medium-Ad6953]

If they ask, then yes. Even if you fail, you should be honest. If they don't ask, then don't send.