Matching into residency is very exciting, but if you’re in a relationship with someone who is also in medical school, the idea of couples matching can be terrifying. Matching, in general, can be scary, as you could be sent to any of the programs you decide to rank. If you have a significant other, this introduces the prospect of being thousands of miles apart for the next 3-5 years.
Long-distance relationships are tough, especially as you both navigate very demanding and challenging phases of your careers. Therefore, ending up near one another is ideal for preserving your relationship throughout residency. This can be accomplished through Couples Matching. Couples Matching is a process in the NRMP – National Resident Matching Program – algorithm that takes into consideration preferences of a couple, rather than an individual.
The process can be confusing, but if you are planning on participating in the couple’s match, then it’s important to understand. Continue reading to learn more about couples matching and how to increase your chances of being successful.
How does the Matching process work?
Couples matching is a “linking” process in the normal NRMP algorithm. During a normal match, a candidate will rank programs in sequential order of preference. Those programs will rank candidates they want, preferencing those that they really want to match at the top.
An algorithm attempts to place the candidate in their highest ranked program. If that program also ranked them in one of the guaranteed spots, then their match will be locked in. If the program ranked them in an un-guaranteed spot, but ranks another candidate, who also ranked them, higher, then that bumps the lower candidate out of the spot. The algorithm, then, attempts to place them in their next highest rank. This process continues until the candidate either matches or runs out of programs and goes unmatched.
How does Couples Matching work?
In couples matching, this process is very similar. However, the algorithm reads their preferences as one. Couples will both select couples match on their NRMP application, which will link their applications. Anyone can participate in couples matching, but both applicants have to agree to participating in couples matching.
Once their applications are linked, they submit their rank order lists. These lists do not have to have the exact same programs, but the combination of programs will go through the algorithm. One applicant can rank the same program multiple times to maximize the chances of matching.
If both applicants are ranked by programs of the same rank, then couples will match at those programs. If one applicant is ranked, but another is not, then the algorithm will go to the next combination and see if they are both ranked. This process continues until the couple is matched, or they exhaust all programs, and both go unmatched.
What if someone goes unmatched?
There are two ways that someone can go unmatched in the couples match. The first way, described previously, is where the couples runs out of programs and neither match. The second way is if one applicant uses a No Match Code, and the other partner matches at that program. A No Match Code is a code that one partner enters if they don’t have a pair program. If their partner matches into that program, then they could potentially not match while their partner does.
Those that do not match will be notified the Monday before Match Day, which always takes place the third Friday of March. Unmatched individuals will enter the SOAP process, or supplemental offer and acceptance program. This takes place Tuesday, Wednesday, and Thursday before Match Day, where programs attempt to fill their open spots with unmatched applicants. Applicants may choose to scramble into programs near their partner, or forgo trying to maintain proximity, and match wherever this is an opening. Participating in SOAP does not guarantee a match in an applicant’s desired specialty. Those that are unable to find a spot by Match Friday may continue attempting to fill open spots, or will reapply the following cycle.
Things to consider before Couples Matching
When you are in a relationship, staying together for residency seems like the end all be all to the match process. However, there are several things to consider before moving forward with couples matching.
The potential of a break-up
When you decide to move with your partner, there is always the chance that the relationship can go south. The break up can either take place anytime during the interview process or into residency. It can be heartbreaking to link your life to someone just for the relationship to not workout. However, it is a real possibility. Matching, in general, is a major stressor. Both people have worked so hard for this one dream, so the pressure is real. Couples matching adds another layer of stress as both applicants try to coordinate with another.
All of this stress may be too straining and fracture the relationship. Feelings may fade and grow for someone else. There can be infidelity. The process of being an intern and working 80+ hours weekly may be too taxing for one to focus on a relationship. Whatever the reason may be, break ups are a potential. Although you can uncouple before submitting your rank lists, once the deadline to make changes has passed, you are contractually obligated to go to the residency program with which you matched. No one wants to picture their relationship ending, but it’s a safe idea to have a contingency plan in case it does.
Matching into a less-desirable program
Couples matching is great when both couples get to match into their top choices. However, many times, unless a couple wants to attend the exact same program, both interview there, and are ranked by that program, someone will be attending a program lower on their list. Since the lists are linked, even if an applicant’s top program ranks them, if their partner does not match at the program on the same ranking, an applicant may not match there. Ranking programs multiple times can help meet the goals of both applicants, but there is always the chance that one, or both, will not match into their top programs.
Different priorities
One of the main struggles of couples matching is that both applicants may have different priorities. When deciding which programs to apply to, everyone should have a list of qualities that are important to them and apply to programs that meet those goals. When couples’ goals are the same, then great, but if not, it can mean one is sacrificing.
Examples of this include applicants who are moved far away from their families because of where their partner matched; individuals who moved to big cities or rural areas when they desire the opposite; individuals who move to high-cost of living areas that stretch their budgets; or applicants that entered specialities or programs that were not ideal.
Before uprooting your lives and potentially making some life-altering decisions, consider what you are sacrificing for what you are gaining and make sure it works out for you in the end.
It is expensive and time consuming
Applying to residency is expensive. Couples matching makes the process that much more expensive. Applicants are given up to 20 ranks on their rank order list for a flat fee. For every bundle after that, there is an increased cost. For applicants who are have many programs to rank, the number of combinations between the two can drive up the cost, quickly. It also takes a lot of time to configure these combinations and make sure there is appropriate correlation between the two lists.
Main Takeaways
Couples matching can be a very fulfilling experience, if it all works out. And for more than 90% of couples match applications, this process is successful. However, there is a lot of time, work, and money that goes into ensuring both couples match. If you have a partner whom you are couples matching with, then I hope this has provided you some insight on what to expect. Really consider, as an individual, and as a couple, what are the best moves for you. If you have couples matched, please leave comments below with advice or stories that may help future applicants.