When Julie Van Baardwijk first moved into her apartment near AUC School of Medicine’s St. Maarten campus, she only knew Eric Tharmathurai as her upstairs neighbor who enjoyed singing late into the night. (“It was good singing, I just wish it hadn’t been at 2 a.m.,” she jokes.) Fortunately, they were able to work out a better schedule: The Class of 2019 graduates started dating later that year and have been together ever since, tackling everything from clinical rotations to residency applications as a duo.
Last year, Dr. Van Baardwijk and Dr. Tharmathurai were two of 2,152 applicants to the National Resident Matching Program® (NRMP) Match who participated as a couple. On Match Day, they got the news they’d been hoping for. Both had earned seats in the internal medicine residency program at the Christ Hospital in Cincinnati, Ohio—their top choice.
What is the Couples Match?
Every year on Match Day, graduating medical students receive an email disclosing the program where they will complete their residency training. The “big reveal” is unnerving for everyone but especially for physician couples who learn—at that very moment—if they will be navigating residency together or as long-distance partners.
Fortunately, the NRMP has a process in place to help couples maximize their chance of staying together. The “Couples Match” allows any two applicants to register as a couple and submit their primary rank order lists to be considered together, typically with the goal of earning positions in the same program or programs that are near each other. The matching algorithm then assigns the couple to the most preferred pair of program choices where both partners secure a match. To see a demo of how the process works, check out these two short videos from the NRMP.
The option to match as a couple has been available since 1984, and participating applicants have historically had a match rate of over 90%. In 2019, applicants who went through the Couples Match attained a PGY-1 match rate of 95.0%.
Applicants don’t need to be married or have any formal documentation of a relationship in order to participate as a couple in The Match. Still, it’s a big decision. Applicants should set aside ample time to think about their personal and professional goals, both individually and in their relationship, and consider the ways in which each is willing to compromise.
“We had multiple discussions on what our plans were and where we wanted to go,” says Dr. Van Baardwijk. “We did a lot of online research figuring out how feasible it was, how the algorithm worked, and how it would affect our chances of matching.”
Ideally, two applicants seeking to match as a couple should have similarly competitive applications for their respective specialties (note, you don’t have to apply to the same specialty). If one partner is a much stronger candidate for residency, they may find themselves making sacrifices in order to match alongside their partner who has fewer or less desirable program prospects.
Developing an Application Strategy
When researching residency programs, start by identifying any baseline requirements for your unique situation. Dr. Tharmathurai and Dr. Van Baardwijk, who are Canadian citizens, began their search by eliminating programs that didn’t offer sponsorship for their J-1 visas.
Once you’ve established a pool of viable programs, it’s a good idea to send out more applications than you would if you were going through The Match by yourself. Regardless of whether you and your partner are vying for the same specialty, you’re bound to have some differing opinions on a given hospital or region, especially after interviewing. Apply to plenty of programs so that once you’re further along in the process, you have the flexibility to cross a few off the list and concentrate on those that seem like the best fit.
One way to get more mileage out of your application strategy? Consider focusing your applications on areas where there are multiple hospitals within a commutable distance. AUC School of Medicine Class of 2019 grads Jason Lee and Crystal Wu recommend applying to “power regions” that offer more opportunities for a couple to live and work in the same city, even if they match at different hospitals.
“Applying to regions such as the Northeast where there is a huge density of programs will allow you to have many different combinations of programs on your rank list where you’d still be in the same city or within a close proximity,” says Dr. Wu.
Dr. Wu and Dr. Lee ultimately decided that the city of Tucson, Arizona held the most appeal for them, and chose to rank two different hospitals at the top of their rank order lists. Dr. Lee matched into diagnostic radiology at the University of Arizona College of Medicine, Tucson, and Dr. Wu matched into pediatrics at Tucson Medical Center for Children. Their programs are just 5 miles apart.
Getting (and Nailing) the Interview
If you and your partner both receive interviews from the same hospital or nearby programs, see if it’s possible to schedule your interviews on the same day. “If you can travel together and save on lodging, that will save you a lot of money in the long term,” says Dr. Lee.
Even if only one partner receives an interview from a given program, it’s worth reaching out to explain your situation and see if they would be willing to arrange an interview for the other partner, whether they applied for the same program or a different specialty within the hospital.
“Say if Julie got an interview somewhere, I would email the coordinator of the program I applied to, saying, ‘My partner’s having an interview here, would it be possible for me to have one as well?’” says Dr. Tharmathurai. “It doesn’t always work out, but the programs often did try for it.”
During the interview itself, Dr. Wu recommends highlighting the Couples Match as part of your long-term goals and how it relates to your interest in the program.
“Be genuine about why you’re couples matching. If you have a specific reason to attend that program, let them know,” says Dr. Wu. “For example, we were especially dedicated to this program because we could envision ourselves settling here not just for a couple of years for residency, but also beyond that—starting a family and committing to the community.”
Dr. Van Baardwijk and Dr. Tharmathurai found that their experience completing six months of clinical rotations in the U.K. served as a strong talking point that helped them stand out in interviews.
“We were able to talk about the differences in medical systems, the benefits of those different systems and what we learned, and I think it really helped us,” says Dr. Van Baardwijk. “But [rotating in the U.K.] isn’t just something good to talk about on interviews—I think it also makes you more adaptable and prepared for residency in general.”
A Foot in the Door: Scheduling an Audition Rotation
Dr. Van Baardwijk and Dr. Tharmathurai say the most important part of their matching strategy was scheduling an audition rotation. Although neither of them initially received an interview from the Christ Hospital, they got an opportunity to prove themselves—and get an insider’s view of the program—after scheduling an elective there.
“It makes all the difference in getting to know people and making a good impression. Showing that you’re a hard worker over the course of a month is a lot easier than just trying to get to know someone in a 15-minute interview,” said Dr. Van Baardwijk. “And, our whole experience that month was awesome. After we interviewed, we decided that the program was going to be at the top of our rank list. We learned a lot and had great support from the residents as well as the attending physicians.”
Setting Up Your Rank Order List as a Couple
With the Couples Match, you’ll need to submit rank order lists of identical length that account for every possible outcome—including the possibility that one partner will match and another will not. If the algorithm doesn’t find a match in the paired ranks that a couple submits, it will not process the match lists separately.
For this reason, couples will often rank the same program several times against a different program on their partner’s list and include combinations at the bottom in which one partner goes unmatched. Check out the NRMP’s guide “Couples: Viewing and Certifying Rank Order Lists” for more details.
“It’s a long conversation when you’re doing the Couples Match,” says Dr. Van Baardwijk. “Our top choices were pretty clear. It’s a little harder trying to figure out those less ideal choices and exactly where you want to compromise further down the rank list.”
“It was a continuous process of changing the lists,” Dr. Tharmathurai agrees. “We always had the Christ Hospital as our number one. But in between you have those thoughts, like ‘Oh, maybe I’d like to live here today,” and then the next day you think, ‘Oh, maybe that place is really nice too!”
The key? Allow yourself plenty of time to edit the list and come to a decision together. “We worked on it a little each day for a few weeks,” said Dr. Van Baardwijk.
Positioning Yourself for Success: Seeking Guidance Along the Way
Remember that whether you’re couples matching or not, you won’t be going at it alone. AUC students are encouraged to speak to advisors and take advantage of the university resources available through the Office of Student Professional Development (OSPD), including residency timelines, guidelines and webinars covering different aspects of the process, and services such as the Physician Match Advisor (PMA) program that give students access to personalized recommendations.
“The Physician Match Advisor program from OSPD was really helpful,” said Dr. Lee. “Both Crystal [Dr. Wu] and I had our respective match advisors. I met up with my match advisor in person to discuss my application and interview strategies and how we were going to navigate the Couples Match. He always kept in contact with me, and we’re still connected.”
Dr. Van Baardwijk found AUC’s residency preparation workshops to be valuable as well. “Prior to interview season, AUC held an information session about interviews, how to approach them and what they’re like,” she says. “Alumni came in as well and talked about their experience. I think that was very helpful.”
Above all, keep your eyes on the prize.
“I was a bit of a nervous wreck before I got my Match Day email, and then opening it… I got really emotional,” says Dr. Van Baardwijk. “Our program just checked all of our boxes. We’re very happy to be here and we feel really lucky.”