The Couples Match: To Do or Not To Do? That Is The Question…

The match is almost here!! After years or even a lifetime of dreaming, studying, and SO MUCH hard work, you are just days away from knowing where your next chapter begins. Where you will finally start your journey to become whatever type of physician you want to be. The envelope is passed to you, that moment when you feel the world stop and all eyes are on you… It’s AMAZING, but also extremely nerve-racking to say the least. After spending hours over-analyzing programs and rank order, it is completely out of your hands. Dr. Sabrina Gerkowicz joins us at SheMD to discuss her experience couples matching as a SheMD and how her and her husband survived the match!

My [now] husband and I did the couples match, and while we got a lot of “oh wows” and “I can’t imagine what that is like,” “how stressful,” “what if one of you doesn’t match,” etc., it was 100% worth it and I cannot imagine having done it any other way.

Adam and I met in medical school and started dating in our third year - of ALL times, on our general surgery rotation that we were on together. I was an aspiring OBGYN, and my husband, an aspiring surgeon and we were so focused on learning and excelling clinically on that key rotation, so what better time to start a new relationship? But we did, and have never looked back since. This was mid-way through our 3rd year and quickly thereafter, the elephant in the room was impossible to ignore… what were we going to do about matching?

Applications for away rotations were due soon (how much do you love VSAS?), and we were both faced with the question very early in our relationship, were we going to take this next HUGE jump - together? We began by applying to the same programs for away rotations and even got to do one together in my home state! The ball was rolling and we had to decide, fast.

For Adam and I, we both had two clear priorities: to be together or as close as possible, and to match no matter what. We knew we were committed to one another so to make these goals happen, we took the leap of faith and went down the couples’ match road; we went on A LOT of interviews; and made a massive spreadsheet (Adam gets all the credit for that, there is no other person on the planet with his attention to detail and organization).

As many of you know, or will know very soon, after you complete all your residency interviews, you then have to rank all of the programs in order (#1 being your top choice all the way down to your last choice). You should rank all programs you would want to or can see yourself training at. And you should NOT rank anywhere that you cannot imagine training at, especially programs that you would be miserable at – that is not a good situation for anyone.

Couples matching effectively merges two peoples’ lists into one, so rather than a single list per individual, it becomes a list with 2 columns if you will. These program “combinations” are then ranked in the order you desire. A key strategy that we found to be helpful here was to look for larger cities with multiple programs (for both general surgery and OBGYN) and to make sure we had a good spread of programs including various degrees of competitiveness (academic, community, and everywhere in between). That way for my option A, we could link it to Adam’s option a, b, c, d (Aa, Ab, Ac, Ad etc. ***nerd moment but I always think of Mendel’s pea plant experiment here), giving us well over 100 pairs or combinations at the end. We were not playing around here!

We scrutinized each combination and we decided to alternate if one of us felt more strongly about somewhere than the other. In alignment with our goals, combinations that would put us in different cities or nearby states were last on our list and we did not include any combinations where one of us went unmatched. Rank order is a very personal decision based on a different number of factors for each person/couple, so take time to make sure you do this step carefully, program by program, or in our case - combination by combination.

Any two applicants can choose to participate in the NRMP Match as a couple, but typically this it done to be in the same geographic location with an important person in your life. Like anything, there are rules to this process – so it is really important to know these details well before starting. Some key points to consider are: you have to be in the same match – so if one person applies to specialties like urology, ophthalmology etc. with early match cycles and the other person applies to OBGYN – that won’t work. Also, a match is made only if BOTH partners match at each program of one of their ranked combinations (each partner matches to their respective institution in that combination). If you do not match at any of your combination of programs, your list is not then re-considered individually – it’s all or nothing. I recommend checking out the NRMP website for full details. (http://www.nrmp.org/couples-in-the-match/).

All these details are definitely not meant to scare anyone, but rather to let you know that this is VERY possible if you go about it wisely, establish very clear goals and priorities together, and want to take that next step of your journey with someone else.

Adam and I were overjoyed when we matched at one of our top combinations, and while we were appropriately nervous to start OBGYN and General Surgery, we got to do it together. Fast forward 4-5 years, both of us decided to apply for fellowship - Reproductive Endocrinology and Infertility for me, Plastic and Reconstructive Surgery for Adam – a step that unfortunately does not allow you to couples match (but that makes sense). So, while we ended up doing long-distance after all (going on 4 years now…), we were able to match in nearby states and we’re so grateful that our first 4 years were together.

So often I have reflected on our process and it fills me with lots of emotion (nearly all good!! But we were definitely stressed out about it while we were going through it). I know how hard it was to get advice as fewer people apply via the couples match route, so Adam and I are happy to talk about it and share whatever we can about the process, both good and bad. Please feel free to message me on Instagram if I can help in any way (@sabrinagerkowiczmd).

Still unsure? Do consider couples match if:

• You are very committed to the person you are couples matching with

• You accept the fact that your match will be fully integrated and tied to someone else’s

• You are clear on all the NRMP rules

• You want to improve the chance that you will be in or near the same place for training

Don’t couples match if any of the above do not apply.

So, after all this, what are some key points to keep in mind about the couples match:

• It is a little more work. It is wise to apply to more programs and go on more interviews to increase the odds of having combinations that both of you will match at, even more so for very competitive specialties. But nowadays, this advice holds true to all medical students. When we applied, the suggested number to apply to was between 10-15 programs, I’m sure that number is much higher today. But as a reference, we applied to over 30 programs, each!

• You may face some stigma. Adam definitely did in the surgery world, me not so much. I’ll never forget how he told me that one program couldn’t believe he would prioritize his relationship over the surgery program… (seriously!). But programs that have a negative attitude toward this were not programs we would want to be at anyways, so better to know that before making our rank list. I hope things have changed, but who knows.

• You should always make sure the program knows that you are applying as a couple. They may be able to communicate to the other department if they really like you and put in a plug for your significant other!

• You will definitely be asked about it on the interview trail. I believe since we were “just” boyfriend and girlfriend at the time, we were probably asked more questions along the lines to “affirm” our level of commitment to one another. The program may ask questions about your connection to the area etc. anyways to make sure you will be happy there, have support, and be a good fit in their environment – not to be nosy. If you are engaged or married, maybe this won’t be such a big deal. Don’t get phased by this, these details should be basic and it should be easy to speak to the truth of your situation.

• But for the right people, this whole process is ABSOLUTELY WORTH IT!

Lastly, please remember to enjoy and celebrate this time. Be grateful and make the most out of your training no matter what program you land at and where it fell on your rank list. YOU MATCHED! Work hard, learn a lot, and be patient - Rome was not built overnight. Do right for your patients and your colleagues. Be a team player, talk to others and ask for advice, no one is in this alone. Medicine is amazing, and the possibilities are truly endless.

Wishing you and medical students everywhere all the best!

Sabrina Gerkowicz, MD

@sabrinagerkowiczmd

#CouplesMatch

#MatchDay

#RankList

#Residency