Applying for residency programs that shape the entire career of young doctors can be extremely stressful. The application process is not simply based on filling out long forms and being interviewed. Program preferences and the ranking involved make the residency application process somewhat complicated. But what if you had a partner who could help you in making tough decisions and provide support while you navigate through your application process? ‘Couple Matching’ can be a real lifesaver in circumstances where you have a spouse or companion who also wants to apply for residency programs. ‘Couple Match’ is a process in which two applicants who are also a couple can associate their Rank Order Lists (ROLs) via the National Resident Matching Program (NRMP). The typical success rate is 95% for people who enter into the system as a couple. The system will consider their applications as a pair and will match both partners to the highest-ranked positions available in the selection pool. It does not matter if your partner is your real-life wife, husband, or best friend; the NRMP system does not require proof of companionship. Simply put, the system ties the fates of two people and allow them to work in the same geographic area.

How does the couple’s match for residency work?

In order to utilize the option for a couple’s match for residency, both partners are required to register themselves on three systems known as the Registration, Ranking & Results (R3) systems. The typical dates for registrations are the 15th of September and the last date for signing up is the 30th of November. The fee for applying for the ‘Couple Match’ residency program is $30. One partner from a couple can submit a request into the system while the other partner can accept the request before February and before the issuance of the Rank Order List (ROL). If one partner wants to change his/her mind and uncouple then he/she must make sure that he/she has uncoupled himself/herself before the issuance of ROLs that is scheduled in February.

The system treats both applicants as a couple and the algorithm will only work if the paired ranks are exhausted. Similarly, the ROL of every partner is required to have a similar number of ranks. However, if the applicant prefers applying to advanced specialty programs by including a “Supplemental Rank Order List,” his/her supplementary Rank Order Lists will be considered as individual by the system and he/she will be only matched on the basis of his/her principal Rank Order List.

Development of ROL as a couple

In order to rank for the desired programs, it is crucial for both applicants to have higher credentials. Both partners must be aware of the limitations and competitive advantages of each other. They need to communicate their individual needs and not limit their options before entering into the system for a successful match. The algorithm treats the credentials of you and your partners as a pair, so if one partner has low credentials, neither partner will be matched to high-profile positions. Consider this your partner might be qualified for a great position at a competitive program, whereas you may match at a less competitive program. Keep in mind that the NRMP will match the couple in a lower-ranked pairing. Additionally, it is recommended to reserve the ‘No Match Code’ at the bottom of your shared list as a couple to prevent being matched solo.

What to do if you don’t get matched as a couple for residency?

There could be multiple reasons for not being matched for residency – non-matching credentials, insufficient research, and applying to fewer programs. However, if an individual does fail to match, he/she can sign up for Post-Match Supplemental Offer and Acceptance Program is known as SOAP. The purpose of participation in SOAP is to be selected for unfilled positions in various residency programs that remained vacant due to other reasons. It’s important to maintain your confidence even if you aren’t matched rather than becoming embarrassed. You can seek help from your medical school, participate in a research project or contact Residents Medical Group, Inc. for counseling and assistance. You can ask to serve as a scribe for a physician or find another relevant job in a clinical setting such as an EHR trainer or volunteer instead of wasting your time by sitting at a home. For instance, in the state of Missouri, you can work as an assistant physician if you have been not achieved a match in a residency program. Additionally, a medical graduate can always improve his/her profile for future residency programs by taking and passing the “USMLE Step 3 exam.” Passing the Step-3 exam can help in landing good jobs for unmatched graduates and can significantly boost your chances for successful matches to residency programs.


‘Couple’s Match’ in residency is a beneficial program that allows you and your partner to work in the same geographic area and be there for each other in times of need. Although the reward for couple match residency program is high, the application process can be a relatively challenging and cumbersome experience. For successful matching, both partners need to communicate and make ranking decisions based on their combined credentials. It’s best to keep your priorities straight and even if you don’t get matched, don’t consider it as the end of the world and limit your options. There are various opportunities for unmatched candidates in clinical settings that can help you achieve residency in the future.