Applying for residency is an intimidating feat for all medical students. But for those whose partners or loved ones are also medical students, thoughts about couples matching may make applications even more daunting. The couples match for residency can be a very difficult decision to make, as both sides have worked incredibly hard and sacrificed a lot to get to this point in their careers.
This post will give couples some guidance on what it means to couples match and what they should consider before making their decision.
“Couples matching” is when two medical students applying to residency decide to “tie” their rank lists together. Many do this in an attempt to match in the same location, but couples may have other priorities too, like institutional prestige and setting (rural vs. urban).
At the end of the season, this means that instead of individual rank lists like this:
Partner A:
Partner B:
Their rank lists will be “paired,” potentially increasing their chances of staying in the same location. A couple prioritizing staying together and staying in Seattle may have a rank list that looks like this:
| Partner A | Partner B |
| 1. University of Washington (Seattle) | University of Washington (Seattle) |
| 2. University of Washington (Seattle) | Virginia Mason (Seattle) |
| 3. Virginia Mason (Seattle) | University of Washington (Seattle) |
| 4. University of Michigan (Ann Arbor) | University of Michigan (Ann Arbor) |
| Etc. |
In order to match at their #1 paired rank, partner A and partner B must BOTH match at the University of Washington. If partner A matches at the University of Washington, but partner B does not, the algorithm will skip #1 and move on to pair #2.
For more information about the couples matching process, check out this video created by the NRMP.
Any two medical students, from any school, are eligible to participate in the couples match. This includes MDs, DOs, and IMGs. They must be applying to the same application cycle, and they must both be applying to specialties that are using ERAS (click here to view those specialties). There is no requirement about relationship status (dating vs. married), type of relationship (romantic partner vs. friend vs. family), or length of relationship.
For long-term couples with children or those with extenuating circumstances, deciding to couples match may be an easy decision. But for other couples who may just be starting their relationship or are less certain, this is a deeply personal and often challenging choice.
If you are approaching application season and need to make a decision within the next few months, I would recommend “reserving a date” with your partner. The both of you are likely very busy with away rotations and personal statements, so it can be helpful to plan ahead and “book” time together without distractions. Prior to discussing together, students have found it helpful to take some time to reflect and write down their individual questions and concerns.
To get you started, here are a few reflection questions you may want to ask yourself and your partner:
If you and your partner are just starting medical school, it’s never too early to start this conversation. It can be helpful to establish a direction early on so that the two of you can think about this over several years and prepare for the challenging decision ahead.
Most importantly, after reflecting with your partner, make sure you get any lingering questions about the process answered before deciding. Consulting your school advisor or older students who have couples matched might provide you with extra guidance and support.
Unfortunately, yes, and you may need to factor in those extra costs when creating your MS4 budget. Here’s the rundown:
Honestly, it depends on what you define as “success.”
In 2023, 1,239 couples participated. Of these couples, 1,095 had both partners match and 114 had one partner match for a match rate of 93%.
Please note that this does NOT mean both partners matched in the same city and were able to stay together (if that is your goal). It also does NOT mean they were able to match within their top 5 or even their top 10. In general, couples match applicants match lower on their list than individual applicants. There are very limited statistics published about the couples match, so there are a lot of unknowns to take into consideration.
Regardless, 93% of applicants who couples match successfully match somewhere, and that is comparable to the match rate of individuals.
The earlier you make this decision (or at least start thinking about it), the better. If you decide sooner, you and your partner can plan ahead, build a support system of alumni and advisors, and generally be prepared with a game plan when you start your fourth year. This is particularly helpful if you or your partner is applying to a competitive specialty that requires audition rotations. You both can identify locations and programs that you would be happy at, and target rotations in desirable cities.
At the latest, try to make that decision before submitting your ERAS application in fall. There will be lots of teamwork required to make interview season a success for both of you. It is crucial to know ahead of time so that you can advocate for each other throughout the process.
Yes. Specialties that are competitive for individual applicants are going to make couples matching harder. This ends up being a numbers game – the more interviews you have, and more specifically, the more interviews you have NEAR your partner, the higher the chance that you will match together. Competitive specialty applicants usually have a harder time getting high numbers of interviews, limiting their couples match potential. Specialties that are easier to couples match with are specialties that are less competitive with high numbers of PGY1 positions, like internal medicine, family medicine, and pediatrics.
Not really. You could try applying to programs individually and ranking programs based on location (i.e. both of your #1 programs are in the same city), but it would be riskier. This may be a good option for couples who want to maximize their chances at matching at their top program, and are okay with the increased risk of not being together.
You may have decided to couples match at the beginning of the season, but things have changed and the two of you find yourselves wanting to “de-couple” your rank lists. Please know that this is allowed and possible (but note that the fees you paid are non-refundable). If this is something you are considering, I would recommend speaking with your school’s advisors immediately for personalized guidance.
Residency is one of the hardest parts of medical training. For medical student couples that want to stay together during this phase of their lives, the couples match could be the perfect solution! We wish all of you the best of luck – the journey ahead is difficult. In the end, we hope that your decision to couples match (or not!) brings you both happiness and peace.
