How to Find Open Residency Positions in 2026: A Complete Year-Round Guide

Every year, thousands of medical graduates finish residency interviews, submit their rank lists, and wake up on Match Day to find they have no position. They are not alone. Hundreds of open residency positions are available outside the Main Residency Match — through SOAP, post-SOAP scrambles, mid-year vacancies, and program expansions — and a clear strategy makes the difference between a wasted year and a residency seat by July 1.

What Are Open Residency Positions?

Open residency positions are unfilled spots in ACGME-accredited residency or fellowship programs that did not match an applicant through the National Resident Matching Program (NRMP). They span every PGY level from PGY-1 through PGY-7 and are available year-round, not just during Match Week.

Open positions typically come from one of five sources:

• Programs that did not fill their slots during the Main Residency Match
• Positions made available during SOAP (the Supplemental Offer and Acceptance Program)
• Post-SOAP scramble positions that remain after Match Week ends
• Mid-year vacancies when a resident withdraws, transfers, or fails to renew
• New positions created mid-year through program expansion or ACGME approval

Why Hundreds of Residency Positions Sit Unfilled Every Year

The Match is highly competitive but imperfect. In any given cycle, hundreds of categorical and preliminary positions go unfilled — and additional positions become vacant throughout the academic year. The most common reasons:

• Lower-prestige programs and rural or community hospitals struggle to attract enough ranked applicants
• Less competitive specialties (Internal Medicine, Family Medicine, Psychiatry) have more positions than top-tier applicants
• Resident attrition — for personal, academic, or visa reasons — creates mid-year vacancies
• New ACGME accreditations open up positions that didn’t exist during the Main Match
• Some programs intentionally hold positions open for off-cycle hiring of strong candidates

Where to Find Open Residency Positions in 2026

Several sources publish unfilled and open positions, but most are fragmented or only active during Match Week. A complete year-round search uses multiple channels:

• Our weekly-updated list of open residency positions covering all specialties and PGY levels
• NRMP’s R3 List of Unfilled Programs (visible only to SOAP-eligible applicants during Match Week)
• ResidentSwap and similar platforms for mid-year transfers between residents
• Direct outreach to program coordinators (the most underused channel)
• Specialty-specific listservs and society job boards

How to Apply to Open Residency Positions Outside the Match

Outside the structured SOAP process, applying to open positions looks different from the Main Match. There is no rank list and no algorithm — applications are reviewed in real time and offers are extended on a rolling basis. The applicants who move first and present a polished package have a significant advantage.

The basic workflow:

• Keep your ERAS application active and updated year-round
• Have an up-to-date CV, personal statement, and 3 strong letters of recommendation ready to send
• Email program coordinators directly with a brief, professional outreach message
• Follow up by phone within 48 hours of email outreach
• Be ready to interview within days, often by video on short notice

Our Application Template Pack includes ready-to-send outreach emails, a formatted CV template, and a personal statement blueprint built specifically for off-cycle applications.

When Are Open Residency Positions Posted? A Year-Round Timeline

Open positions appear in predictable windows throughout the academic year. Knowing the calendar lets you focus your search at the right time:

• March (Match Week): The largest single drop of positions through SOAP and the immediate post-SOAP scramble
• April–June: Positions still being filled before the July 1 start date
• July–August: Early-year resignations and PGY-1 attrition create vacancies
• October–December: Mid-year departures, often around academic mid-points
• January–February: Programs filling remaining vacancies before the next cycle

The video below summarizes the post-SOAP landscape and additional resources for applicants who didn’t match the first time around:

Open Residency Positions by PGY Level

Availability varies dramatically by PGY level. The Main Match and SOAP dominate the PGY-1 picture, while higher PGY levels rely more heavily on off-cycle vacancies and direct outreach.

• PGY-1: Largest pool by far. Categorical and preliminary medicine and surgery positions are most common, with a substantial number filled through SOAP each year.
• PGY-2: Vacancies appear when a PGY-1 leaves a program. These spots are rarely advertised broadly and are the strongest case for direct outreach.
• PGY-3 through PGY-7: Less common but exist — particularly in advanced positions, fellowships, and surgical subspecialties where attrition is meaningful.

Specialties With the Most Open Residency Positions

The specialties that consistently have the most open residency positions outside the Match include:

• Internal Medicine — largest pool, accessible to the widest range of applicants including IMGs and DOs
• Family Medicine — strong community program presence and IMG-friendly
• Psychiatry — growing demand and a steady number of unfilled positions each cycle
• Pediatrics — moderate openings, particularly outside major metro areas
• Neurology — available at both academic and community programs
• Pathology and Radiology — smaller pools but persistent year-round openings

For an estimate of your competitiveness across these specialties, our free Match Chances Calculator uses your Step scores, clinical grades, and research experience to project your chances by specialty.

Direct Outreach: How to Find Hidden Open Residency Positions

The most underused strategy is also the most effective: directly contacting program coordinators about positions that may not yet be posted publicly. Coordinators often know about a resignation weeks before a job is officially listed, and a polished, professional outreach email frequently lands an interview when the position becomes available.

The outreach protocol:

• Identify 20–30 target programs in your specialty using our list, ACGME’s program directory, and FREIDA
• Send a tailored email to the program coordinator referencing the program by name and explaining your specific interest
• Attach a one-page CV and a short paragraph (not a full personal statement)
• Call the coordinator 24–48 hours after sending the email if you have not received a reply
• Track every contact in a spreadsheet so you can follow up systematically over weeks

Our SOAP Survival Kit includes word-for-word email templates and phone scripts originally designed for SOAP that are equally effective for year-round outreach.

Frequently Asked Questions

Can I apply to open residency positions if I’m already in a program?

Yes. Residents leave programs every year for personal, geographic, or specialty-change reasons. The process is similar to off-cycle applications — you contact target programs directly and provide your current program director’s permission or a release letter once you’re at the offer stage.

Are open residency positions available to IMGs?

Yes. Many programs with open residency positions actively recruit IMGs, particularly in Internal Medicine, Family Medicine, and Psychiatry. Eligibility requirements (ECFMG certification, visa status, USMLE Step scores) still apply program-by-program. See our detailed guide on open residency positions for IMGs.

How quickly do open residency positions get filled?

SOAP positions fill in 4 days. Post-SOAP positions can fill in days or weeks depending on the program and specialty. Mid-year vacancies sometimes sit open for months in less competitive markets — which is why a persistent direct-outreach strategy works.

What official resources should I use alongside this list?

The NRMP’s SOAP page is the authoritative source for SOAP rules and eligibility. The AMA’s residency resources include year-by-year SOAP statistics and applicant guidance.

Open residency positions are available year-round across every specialty and PGY level. Our weekly-updated list, SOAP Survival Kit, and Application Template Pack give you the complete toolkit to find and secure a position outside the Match. Get lifetime access for $39.95.