I'm not a PD, just an MS4 who is couples matching this year. I would say IM & Psych would be the better route to go. You have to look at it from the program's perspective. Most places only take 4-8 residents per year. That basically eliminates all of the small programs from your potential match. Why would they want 2 of their 4 residents to be a couple? You're going to want the same time off for vacation, maternity/paternity leave, etc. What if you guys break up? Big risk for them. Even places that take 6 residents. Now 1/3 of the intern class belongs to one couple. Big risk. Tack on the fact that you're a DO and not an MD and it gets even worse. That's just my two cents. Fingers crossed that couples match works out in my favor with my girlfriend. She's going for FM, and psych for me. We interviewed at 12 places, but are only ranking 10 of them. 9 of those 10 are in the same city and 1 our of combinations is an hour apart, driving distance.