Matching into residency can be extremely stressful, regardless of your scores or specialty. Finding programs to apply to, scheduling away rotations, traveling to interviews, and trying to decide how to rank programs is a completely new experience for most medical students. Add the stress of incorporating another person into the process and it becomes overwhelming. Additionally, the couples match is poorly understood by many and requires strategy to successfully complete. This past spring, my fiancée and I matched into our first choice program after a year of planning and nail biting. Here is our guide to navigating the couples match.
Let’s start off with the basics: the NRMP couples match is not a combined application process! Each student will create his or her own application and interview separately. Many programs will have no idea you are couples matching unless they read through your entire application. Don’t expect your advisor or school to know the ins and outs of couples matching—so be proactive; elicit advice from successfully matched interns/residents. Never assume a program knows you are couples matching, or that a program will communicate with your partner’s program/department. Look for programs that advertise as “couples friendly.” Many programs will flat out refuse to contact another department or help your partner (I’d recommend canceling interviews to unfriendly programs as it is a symptom of other issues).
Let’s get going!
1. Prepare: This goes without saying, but make sure you are both putting your best foot forward. You need to maximize your step 1 and step 2 scores, get great reviews on your rotations, and make sure your research and other projects are filling out your CV well. Together, discuss realistic goals and priorities to boost your CVs. It’s normal for one partner to have a higher Step average, but remember that your applications are considered individually. To ensure a good match, each partner needs to be a good candidate for their field. If away rotations are important in your field, be proactive about finding programs you each can rotate at. Consider rotating at different programs to maximize your exposure as a couple. Consider meeting with the program director of your couple’s department while rotating.
2. Be Honest (with each other): Start discussing couples matching by 3rd year of med school. This is not a casual decision, and if things go sour you may be stuck in the same program or hospital, and possibly even a mortgage with this person. Have frank discussions about your professional and personal goals, and how geography, institutions, and the rest of life falls into that. If there are red flags or low scores in your partner’s application, would you be bitter if you were unable to go to your first choice? What if one person doesn’t match? The match process is stressful and can easily build resentment and strain in a relationship. Honest, open communication throughout the process is the most important key to making sure everyone is happy with the outcome.
3. Make a List: Before the NRMP opens, you should each make a list of every program you want to apply to. Then grab a bottle of wine, two laptops, and go through each program together to create a single excel sheet. Going into Emergency and Radiology, we applied to 72 programs. The number you apply to will depend on what specialties you are targeting. Keep your options broad— you can always decline interviews later, and you don’t have to rank every program. Concentrate on applying to multiple programs within the same city to increase possible match options. Chicago is a great example of a city with multiple programs.
4. Self-Identify: You should mention that you are couples matching in your personal statement. It only takes 1-2 sentences, but this might be the first time a program realizes you are couples matching.
5. Know how to answer: You will get questions about a future wedding, kids, family life, etc., so be prepared. Asking about wedding plans, how you met, where family is located are all questions I was asked quite often. Answering confidently is more important than what your answer is. No program wants to match a resident who is bringing drama. Your goal is to show your relationship is robust, and matching is a joint decision.
6. Start writing emails: Once interviews start coming in, add the interview dates and rejections to the excel sheet. Keep it up to date to prevent headaches later on. If one partner gets an interview, they should each contact their respective department. For example, Jane (radiology) and Bob (Emergency) are matching together and Jane gets an interview. Jane should email the radiology department and ask if they could contact the emergency department. Bob should email the emergency department and explain radiology has invited Jane for an interview, and to please consider his application. Include both of your NRMP numbers and full names in each email. This is a delicate task; you don’t want to sound pushy. Each request should be personalized to that program. Never send out generic emails! Keep in mind these program coordinators are looking at hundreds, possibly thousands of applicants. The goal is to get interviews in as many of the same programs as possible. As a last ditch effort, you may consider calling programs, but this is only when your options are limited.
7. Reconsider your list: Review the excel list each week. Hopefully a large number of interviews are coming in. It’s probable you will each get interviews at programs or cities your partner does not. If you are rejected from a program, and there are no other possible couples match options nearby, your partner may want to consider canceling the interview to save energy and money for other interviews.
8. Be Honest (with programs): As you narrow down your top picks, you should consider contacting the top one or two programs. Never lie to a program about your intentions, and never expect a program to respond to your messages. For most programs, they are strictly forbidden from discussing with you anything about ranking, and could lose their ability to participate in the match if they violate rules. With that said, consider emailing the director of your top pick and be frank with them about your intentions. This candor should also be a part of your interview day as well. Keep in mind these programs will probably talk to your partner’s department, so make sure you are on the same page.
9. Create your Rank List: Time to bring back the bottle of wine. Below is our own theory for rank lists. Here is a more in-depth look at making a rank list. The first goal of your rank list is for both of you to match. The second goal is to be in the same region or city, and finally, the third goal is to match at your choice positions. As a couple, your match list MUST be extensive. Every possible option, as well as match/no match options should be put into the list. Below is a very basic example of a match list. Your list will probably have >80 different iterations. In green is all matches that would place this couple together in “Chicago.” As you can see, you can rank the same program multiple times, so you should put every possible “Chicago” iteration into your list. Next, this couple decided to rank NY programs, however Partner 2 only interviewed at Hospital D, so Partner 1 listed two programs with partner 2’s single hospital. Finally, in yellow, the partners will list any possible matches that would result in both of them matching outside the same city. These aren’t ideal, but are better than not matching at all. Then red matches are the final picks, you should rank EVERY program individually with a no match for your partner.
Evan Kuhl is a PGY-1 emergency medicine resident at The George Washington University in Washington, DC. Evan is interested in the intersection of sports and medicine, and is an avid cyclist. His website, www.evankuhl.com, includes helpful tips for pre-med and current medical students.
• Residency Applications: How to Match, a free webinar
• MD, OBGYN, MPH Talks Med School and Residency Admissions, a podcast episode
• What’s the Best Way to Prep for Your Residency Interview & How Can Accepted Help?