Matching into a residency program is the culmination of four (or more) years of incredibly hard work and determination. This process does not come without an abundance of stress, fear and at times, self-doubt, at least in our experience. Those that are seeking to couple’s match face a magnified challenge in that they need to not only impress a residency program in a specific city or region, but have their significant other do the same, ideally in the same city or region. We are facing the couple’s match in 2018 and would like to share the advice we have received from our advisors, professors, friends in medicine and our own thoughts on the couple’s match and planning away rotations.
One of the hardest aspects about attempting to couple’s match is the paucity of data that exists on the topic. For those unfamiliar with the process, the National Residency Match Program (NRMP) allows any two applicants to “couple” by linking their residency program rank lists so they can match to a desired pair of programs (often done for location purposes). The NRMP publishes an abundance of data each year breaking down the nitty gritty details of the match for that year, complete with breakdown by specialty. However, we have found a striking lack of analysis of students who have declared that they are couple’s matching. The only statistic available from the NRMP is that a record-high of 1,046 couples participated in the 2016 Match, 11 more than in 2015. Furthermore, 95.7 percent of those declared as couples matching were matched to first-year positions, the highest on record with the NRMP. A recent blog post written by @Ashleygrl explains two reasons why this data may be skewed and gives a more detailed breakdown of the couple’s match.
Advice for the Couple’s Match
As one might expect, the limited information makes the process of couple’s matching all the more anxiety-provoking, especially in situations where both individuals desire a highly competitive specialty. We have had many open and honest conversations with each other before seeking specific advice from our advisors and we knew that in order to successfully make it through this process, we would revisit these conversations again and again … and again. This thought mirrored the best piece of advice we received. It came from Dr. Mitchell, the marvelous dean of our medical school, and it was to simply talk about everything. While we would never dream of asking one another to put their dreams on hold for the other, we know couple’s matching is not without compromise. Discussions regarding residency should be a fluid process. When you decide to couple’s match, your dreams are linked. We have been wholeheartedly supportive of each other’s dreams from the start in each of our pursuits of a medical specialty.
Compromises and Sacrifices
There will be a point, both when deciding on away rotations and when ranking programs, where both individuals need to assess what is more important to them: getting into a specific program or going to a certain geographical location. Reasons for the former include prestige of the residency, quality of training or fellowship connections. Reasons for the latter include closer proximity to friends and family and a higher concentration of programs in a location that can increase chances of being together. To add a layer of complication to the mix, different institutions are often better known for specific medical specialties. Therefore, what might be a dream program for one person may be a less desirable option for the other, necessitating discussions regarding what each person is willing to sacrifice. For away rotations, we were able to identify programs each of us liked from a training standpoint that also have additional programs in close proximity. Ideally, this will help facilitate our ultimate goal of living together for residency. For other couples, it may be more important for one person to get into a specific program, even if that means a further commute to the other partner’s residency location. There is no right or wrong. Each couple has different goals going into the couple’s match; you just have to find what works best for your situation and make it a frequent point of conversation. Establishing goals through tough conversations early on will help ease some of the tension over decision-making later on.
Be Realistic About Your Applications
We would be remiss if we did not state for those who are couple’s matching that you have to be realistic about your application and how the two of you look together on paper. Board scores, grades (particularly in the clinical years), honors and awards, letters of recommendation and extracurricular activities matter every bit as much as if you were applying as an individual. However, when couple’s matching, both parties need to carefully consider the strength of their partner’s application as well. If one partner is not a strong fit at that institution(s), then no matter the strength of the other, alternative plans might be in order.
Another piece of advice we received was to choose away rotations in cities with at least two programs, but preferably more. This is sound advice, as large cities like New York or Chicago offer five or more programs in nearly every specialty, allowing a multitude of ranks within the same city (albeit not necessarily at the same institution). In addition, from speaking with our advisors and medical colleagues, if one partner is offered an interview at a program while the other is not, it is 100 percent acceptable to kindly call the program or have program directors reach out. Letting them know that your significant other is interviewing there and that you have a strong interest in the program as well is one way to gain interviews at programs that may otherwise pass over your application. A gentle, respectful nudge might go a long way in terms of gaining interviews, as many programs value the happiness of their residents. We have several friends who are currently in the process of couple’s matching and they have stated that many programs (in a diverse range of specialties) are very receptive and are used to receiving these requests. A longer rank list only betters the chance to not only live together but also to match into your desired specialty.
While no one at our institution has much, if any, experience specifically advising those trying to couple’s match into dermatology and orthopaedic surgery, the advice we have gotten has led us to this: we are going to do everything we can to maximize the number of ranks in the same city (or neighboring city) in order to be as close to each other as possible during residency, even if that means not matching into our “dream” programs. While the coming months are sure to be stressful and test our relationship like never before, we have faith that our love and support for each other will endure and we will both come out smiling on Match Day 2018.