Authors:  Caitlin Schrepel MD, Adam Kellogg MD, and Emily Hillman MD on behalf of the CORD Student Advising Task Force  

The CORD Student Advising Task Force created the Emergency Medicine Applying Guide as a comprehensive guide to help navigate the Emergency Medicine match process. This post is meant to supplement that information for those applicants who are also applying to the Couples Match. Information in this guide is a compilation of medical student advising guides, resident advice and the authors’ experience in couples matching into emergency medicine (EM).

First, a little advice

Prior to applying as a couple it will be important to set expectations. The process can be expensive, time consuming, and extra stressful. It is important to meet with your medical student advisor in advance to discuss the process and determine appropriate goals based on your specific situation. You will also need to take into account that you and your partner may not be evenly matched in terms of competitiveness and this may influence the number of programs to which you or your partner apply.

What is the Couples Match?

National Resident Matching Program (NRMP) gives any two people the choice to match to residency by linking their rank lists together. You will apply and interview separately, but when you create your rank list you will create combinations from that list. You will both then match at the highest rank combination in which both partners have been accepted. You can designate that you are applying as a couple on ERAS, but you do not have to officially decide on couple’s matching until you submit your final rank list1,2.

For more information on NRMP logistics visit: http://www.nrmp.org/match-process/couples-in-the-match/

Things to think about before you apply

• This may seem obvious, but it is important to have a conversation about your professional and personal goals. What does couples matching mean to you? What compromises are you willing to make? What compromises are you not willing to make? Is this the right choice for you and your partner? This is important whether or not your partner is your husband, life partner or best friend.
• Decide in advance whether you would rather go unmatched or match to different programs / cities.
• You cannot enter the Couples Match with someone in a specialty that participates in early matching such as: ophthalmology and urology or with someone matching through the Military Match2.
• Talk with your advisors separately and as a couple to come up with appropriate goals.
• Optimize your chances of matching with a few tricks:
  • If your partner is interested in a program in a particular city, consider doing an away rotation there.
  • If your partner is applying to a competitive specialty, or if you are applying broadly geographically, consider more than one out of town rotation.
  • If your USMLE Step 1 score is <220, taking Step 2 CK early so that it is available when ERAS opens. Scores less than 220 may make it much more difficult for you to get interviews3.

Now it is time to complete your application  

Where to apply?

Here are some things to consider:

• Some cities are great for couples matching because they have multiple programs in many specialties: e.g. Boston, New York, Chicago.
• You may be able to couples match in nearby cities if there is a midway point that is livable and easily accessible to both programs2.  
• Decide in advance if you and your partner want to be at the same hospital2.
• If you are both applying EM, think about if you want to be in the same program (which can be tricky, especially in smaller programs).

How many programs to apply to?

• In general, each partner should aim to rank about 12-15 programs. The number of programs to which you and your partner need to apply to will depend largely on their specialty and both partners’ competitiveness.2 That may mean applying to 25 programs for an EM/IM couple and 40+ programs for an EM/Dermatology couple.  If one partner is not as competitive, consider applying to a surgery or internal medicine prelim intern year as a back-up option.

Who should know my match status?

• Most people will tell you that applying as a couple is seen as an advantage. Residency program directors like to know that you will have a support system in residency, so a partner who understands exactly what you are going through is a good thing. This also gives program directors the opportunity to advocate for matching you by connecting with your partner’s program2. Here are some things you should know:
• You are not required to tell programs that you are couples matching and you can wait until you are making your final rank list to officially decide to couples match. No one will know unless you tell them.
• You can tell programs in several ways (on the ERAS application, in your personal statement, during the interview and/or in follow-up or thank you letters).
• If you are still undecided about couples matching at the time of filing the ERAS application, you should now indicate that you are applying as a couple because you will get asked about your partner if it is on your application.

The risks and benefits of disclosing your match status    

Some potential benefits:

• May be able to coordinate interviews and save money
• Possibility for one program to lobby for an applicant’s partner: For example, if your partner’s program really likes them, that program may lobby your program to offer you an interview or even rank you higher on their list.
• When your interviewer asks you why you want to move to that particular city or be part of a particular program, in addition to the reasons you like their program, you may be able to say that your partner enjoyed their interview day, has family in the area, etc.

Some potential risks:

• Small programs may prefer not to take applicants from the same school/city.
• If you are both applying to EM, programs may be concerned about any drama a couple may potentially bring to a small program.
• If you are still on the fence about couples matching, programs will be treating you as a couple anyway. This may change your rank on their list even though you decide in the end not to enter the Couples Match.

Tricks for the Couples Match interview

• If your partner gets an interview at a program you have applied to and you have not heard from that program, it is fine to email them to check-in on your application status so that you can maximize your chance of interviewing at the same program at the same time2.
• Do not lie on the interview trail. Programs should not be asking you if you are married/engaged/dating, but some will (or residents may ask at the social events). If you are not married or engaged, do not tell them otherwise, programs will find out and this may affect your application.
• If your partner has personal connections to a city or program, bring this up in the interview.

The Match list

This is often the most stressful part of couples matching.  As you figure out how to compromise, grab a bottle of wine and think about some of these things:

• Make your lists individually before comparing them to get a starting point.
• When making your rank list try to organize by cities (programs within the cities) rather than organizing by individual programs.
• What are your priorities?2
  • Living together- all matches need to be within commuting distance.
  • Both partners matching as close to their top choice as possible- you rank top choice programs first keeping in mind how far away you are willing to live.
  • Getting one partner into a particular program- maximize this possibility by ranking this partner’s number one choice with all possible combinations prior to moving on to their second choice.
• Are you willing to have both partners go unmatched? If not, at the end of your list of combinations consider creating combinations where one partner matches and the other does not.

Summary Points

• Educate yourself about the process early at: http://www.nrmp.org/match-process/couples-in-the-match/
• Talk with your student advisor about realistic goals for number of applications, interviews and programs to rank for your specific situation.
• Communicate clearly with your partner about your goals and priorities.

The Couples Match is different for every couple, so it is important to figure out how it will work best for you. Remember that despite the stress, this process is meant to help you and your partner!

References:

1. “Matching as a Couple.” The Match National Resident Matching Program. Web. 08 Jan. 2017.
2. “Introduction to the Couples Match.” Couples Match Guide. University of Washington School of Medicine.  Web. 8 Jan. 2017. http://www.uwmedicine.org/education/documents/md-program/UWSOM-Couples-Match-Guide.pdf
3. National Resident Matching Program, Data Release and Research Committee: Results of the 2016 NRMP Program Director Survey. National Resident Matching Program, Washington, DC. 2016.http://www.nrmp.org/match-process/couples-in-the-match/