The Couples Match: Navigating the Trail Together

To the Editor: “Are you ready for the Match?” was a question we heard often during our last two years of medical school. Ours was a match for more than one person. The outcome would affect our family for the next unknown number of years. Thankfully, in March 2015, we successfully matched as a couple at the same hospital for both preliminary and advanced positions; however, many married and unmarried couples did not receive such good news. Our joy on Match Day stood in stark contrast to the sorrow of another married couple sitting near us; both individuals were in tears after matching at institutions far from each other. Couples participating in the National Residency Matching Program (NRMP) Match process have steadily increased over the past 30 years. The 2017 Match saw the most ever couples—1,125—with a high success rate (95.4%) for matching1; however, since coupled applicants are allowed to submit rank lists with limitless match combinations, including those that would place them hundreds of miles apart, this “success” rate fails to account for whether a couple matched within the same geographical area. A major stressor for couples participating in the Match is the disorganized process for applicants. The few resources that do exist uniformly provide one piece of advice: Have a strategy. The most important part of that strategy is informing programs early and often that you are looking to Match as a couple. This goes beyond checking the box on the electronic residency application service application to indicate that you are a couple matching. It means referencing your hope to match as a couple both when scheduling and attending interviews, in your medical student performance evaluation, and in thank you notes and ranking e-mails to program directors. We strongly encourage residency programs and the NRMP to create a more organized, informative process for couples that, at minimum, addresses the following: Interview coordination: When one candidate is granted an interview at a program, the acceptance should automatically trigger consideration (and notification) of the other applicant for an interview or rejection. This would reduce the anxious waiting and awkward phones calls and e-mails to program coordinators. Program director awareness: Better communication among nearby institutions is needed to support couples hoping to match to the same location. Firm linking of a preliminary year to the Couples Match: Allow both preliminary/transitional programs and advanced programs to be a part of the Couples Match, rather than simply the advanced programs. As it stands, couples are able to list preliminary year preferences, though they may still end up at prelim programs far apart from each other while being considered “couples matched” for their primary residencies. The Couples Match presents a logistical challenge for residency programs and the NRMP, but it is essential that this challenge be adequately addressed to ensure the happiness and well-being of future couples in medicine. Matthew D. Alvin, MD, MBA, MS, MAPostgraduate year 3 diagnostic radiology resident, Department of Radiology and Radiological Sciences, Johns Hopkins Medicine, Baltimore, Maryland; [email protected]; ORCID: http://orcid.org/0000-0003-0362-1526.Madeleine L. Alvin, MD, MAPostgraduate year 3 resident, Department of Pediatrics, Johns Hopkins Hospital, Baltimore, Maryland. First published online February 6, 2018