Open Residency Positions 2026: Complete Guide to Finding Unfilled Spots After Match

Every year, thousands of medical school graduates don’t match on Match Day — and every year, thousands of open residency positions go unfilled. The gap between unmatched applicants and unfilled programs is real, and knowing where to find those positions is the difference between starting your residency on time or waiting another year.

This guide covers everything you need to know about finding open residency positions in 2026, whether you’re navigating SOAP week or searching outside the official Match window.

What Are Open Residency Positions?

Open residency positions are program slots that remain unfilled after the NRMP Main Residency Match. They exist across all specialties and PGY levels — from PGY-1 categorical slots in Internal Medicine and Family Medicine to advanced PGY-2 and PGY-3 positions in Surgery, Psychiatry, and beyond.

Programs may have open positions for a variety of reasons:

• A matched applicant withdrew or was disqualified
• The program expanded its class size mid-cycle
• The program did not fill during the main Match
• A current resident departed unexpectedly, creating a mid-year opening

How Many Open Residency Positions Are There Each Year?

According to NRMP data, over 1,000 positions go unfilled after Match Day in a typical year. During SOAP (Supplemental Offer and Acceptance Program), most of these positions are filled within 4 days — but positions continue to open throughout the year as programs adjust their rosters.

The specialties with the most open positions historically include:

• Internal Medicine — consistently the largest pool of open PGY-1 slots
• Family Medicine — hundreds of open positions every cycle
• Psychiatry — growing demand, frequent openings
• Pediatrics — moderate openings, especially in community programs
• Neurology — open spots available outside SOAP as well

How to Find Open Residency Positions in 2026

There are three main approaches unmatched applicants use to find open residency positions:

1. SOAP (Supplemental Offer and Acceptance Program)

SOAP runs during Match Week and is the official NRMP process for filling positions. Only applicants who did not match are eligible. Programs release their open slots on SOAP Day 1, and applicants have a limited window to submit applications. Speed and preparation are critical — programs can fill within hours.

Our SOAP Survival Kit gives members a day-by-day strategy guide, email and phone scripts, and a printable master checklist to navigate SOAP week effectively.

2. Direct Program Outreach (Post-SOAP)

Positions that don’t fill during SOAP, or that open mid-year, are filled through direct outreach. This means emailing and calling program coordinators directly. Having the right contact information and a compelling outreach email is essential.

3. Curated Open Position Lists

Searching for open residency positions program-by-program is extremely time-consuming. A curated, actively managed list that compiles open positions across all specialties — updated weekly — saves days of research and ensures you don’t miss new openings.

What to Include in Your Application for Open Positions

When applying for open residency positions outside the formal Match, programs typically want:

• Updated CV (formatted specifically for residency applications)
• Personal statement tailored to the specialty
• USMLE Step scores and transcripts
• Letters of recommendation (at least 3)
• A concise, professional outreach email

Our Application Template Pack includes a ready-to-use CV template, personal statement blueprint, ERAS activity descriptions, and outreach email templates — all updated for the 2026 application cycle.

How to Assess Your Chances

Before applying, it helps to understand where you’re competitive. Our free Match Chances Calculator estimates your competitiveness across 18+ specialties based on your Step scores, grades, and research experience — helping you focus your applications strategically.

Frequently Asked Questions

Can IMGs apply for open residency positions?

Yes. Many programs with open residency positions actively recruit IMG applicants, especially in Internal Medicine, Family Medicine, and Psychiatry. Our list identifies IMG-friendly programs explicitly.

Do open residency positions pay the same as matched positions?

Yes. Salaries and benefits for open residency positions are set by the program and institution — not by how you entered the program. An open position pays exactly the same as a matched slot.

How quickly do open positions fill?

During SOAP, positions can fill within hours of being released. Outside of SOAP, timelines vary by specialty and program, but competitive applicants who reach out early have a significant advantage.

Open Residency Positions maintains a comprehensive, weekly-updated list of open PGY-1 through PGY-7 residency and fellowship positions across all specialties. Get lifetime access for $39.95 — one-time payment, no renewals.