couples match scenario: ENT/rads. Please advise.

[martinD28]

Hello.

We are both third years in an allopathic school. We're competitive. Both are in 255-265 Step 1 range, one is junior AOA/other should be senior AOA. Have research, normal personalities, etc.

Hopefully someone can explain this to me: how do I, doing a transitional year and then rads, and her -- starting with ENT, couples match with us guaranteed to be in the same city for my transitional year and then for the next year?

Our number one priority is to be in the same city, we would go just about anywhere to any solid program.

I know someone out there can eloquently explain the couples match algorithm for this scenario. Thank you in advance. After my first meeting with our student dean, I was unable to secure any helpful answers ("Let me get back to you on that").

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[NotAProgDirector]

The answer is: "You can't".

The couples match will link your Rads categorcial match with her ENT categorical match. Your prelim/TY year is NOT couples matched. And you can't design your match list such that if you don't get the prelim you want, that you move down your categorical match list further. (i.e. if you both match for Rads/ENT in city A, but don't get a prelim in city A, you can't make the match move further down your list to city B)

So what do you do?

1. You apply to cities with many programs. There will always be prelims in NYC, Boston, etc.

2. If you apply to small programs, you have to find out if they somehow guarantee a prelim. Else, you're taking a risk of a year apart.

 

[PeepshowJohnny]

From the NBME
"If both partners match to advanced programs, their supplemental rank order lists are not treated as a unit in the Match. The coupling function is done only for the primary rank order lists of the two partners. Any supplemental list will be considered individually and not paired with the partner's corresponding supplemental list."

Basically, you have to decide what's important to you. Guaranteeing spending first year together (in which case you have to be willing to scarmble into a prelim med or surgery in the same town) or an easy year (in which case you live first year apart and come back for your advanced)

 

[Samoa]

If, on your supplemental rank list for each advanced program, you only list prelims in the same city as your advanced match, and you and your SO set up the rank list so that you either both match in the same city, or one doesn't match at all, then you are guaranteed to be together the whole time.

You may end up not matching to a program on your supplemental list, in which case you'll have to scramble. But if you're as competitive as you say, that is a very unlikely scenario.

 

[BlondeDocteur]

And you can always sacrifice the TY for a prelim medicine/surgery year, so that you'll be more or less guaranteed to match in the city your advanced lists land you in.

 

[BobA]

agree with blondedoc.

Also, if it's any consolation, when you're both interns you may not see each other much anyway

 

[dragonfly99]

Agree with samoa and blonddoc
Also, it looks like you are both very competitive candidates, and as long as you aren't married to the idea that you must go to Harvard/UCSF/Hopkins or bust, I don't see how you wouldn't be able to match in the same city...you can probably even match into the same program/hospital if you want. Find out which medical centers are more friendly to couples match folks...ask around among people you know, your med school, etc. Don't worry too much...being competitive candidates means you have more bargaining power vs. other applicants...there are plenty of programs/hospitals that would likely be happy to have two residents like you, assuming you have good LOR's and honors grades in your specialty of choice.

 

[Iwy Em Hotep]

I am going through the couples' match this year (Derm/IM) and would give the following advice for future couples:

1) Try to do your internship at your home program. You should both have reasonable good chances of matching there, or at least somewhere near home. Trying to interview for internship positions in other cities is hugely expensive in terms of money and available interview time.

2) Don't declare yourself as a couple. Much of your interview will be focused on this if you do, and it detracts from your personal application. Go through the interviews alone, and then declare yourself as a couple when ranking.

3) Focus your efforts on major cities, especially west coast ones if you're west coast, midwest ones if you're midwest, etc.

 

[LadyGrey]

2) Don't declare yourself as a couple. Much of your interview will be focused on this if you do, and it detracts from your personal application. Go through the interviews alone, and then declare yourself as a couple when ranking.

Sorry if this is too OT, but I was at one interview where the PD actually interviewed a couple together. Like in the same room, not just on the same day. Is this common, or as weird as it seemed to me? I think it would be weird to have a couple in the same program. Same hospital I've seen, and that doesn't seem like a problem, but in the same residency?

 

[NotAProgDirector]

Sorry if this is too OT, but I was at one interview where the PD actually interviewed a couple together. Like in the same room, not just on the same day. Is this common, or as weird as it seemed to me? I think it would be weird to have a couple in the same program. Same hospital I've seen, and that doesn't seem like a problem, but in the same residency?

I agree that a double interview is weird. When we interview couples both looking at our program, they get separate interviews. I might meet with the couple at the end of the day to answer any questions they may have.

There is nothing weird about having a couple together in a residency program. In this case, we simply make sure that the two people are not on the same service at the same time. We try to overlap on call / non call blocks, to maximize time off together. We also try to line up call schedules, so that days off fall together. And we of course make sure that vacations fall together. Most of this is impossible if the couples are in different programs.

There can be rough spots -- if one is chosen for chief and not the other. Or worse, if one fails out. But, if handled appropriately, both of these can be managed.

 

[gutonc]

Sorry if this is too OT, but I was at one interview where the PD actually interviewed a couple together. Like in the same room, not just on the same day. Is this common, or as weird as it seemed to me? I think it would be weird to have a couple in the same program. Same hospital I've seen, and that doesn't seem like a problem, but in the same residency?

We have a few married couples in our program, as well as several residents who are married to residents in other programs. Those are the ones where things get messy because they never have the same days off and (particularly for those married to surgery residents) vacations and holidays can sometimes be hard to plan together.

I agree that the interview together would be remarkably strange.

 

[dragonfly99]

Why would it be weird to have a married couple in the same residency program? We had a married couple in our IM program, and nobody thought it was weird at all. Actually we had one in our year and one in the year behind us...it's pretty common in medicine and peds, from what I've seen. I guess it might be a little weird if you were in an ENT program with 4 residents/year and 2 were a married couple, but if they are one of 35 IM residents it's no big deal at all.

 

[LadyGrey]

Maybe I'm the weird one, then. It seems odd to me because I like to keep my personal and professional life very separate. I would be extremely uncomfortable being in the same program as my husband. Even the same field would be problematic for me. But my perspective is obviously influenced by having a non-medical spouse, and having this all be in the realm of hypothetical.

 

[fakin' the funk]

2) Don't declare yourself as a couple. Much of your interview will be focused on this if you do, and it detracts from your personal application. Go through the interviews alone, and then declare yourself as a couple when ranking.

I disagree. Withholding that information is both (partially) dishonest and counterproductive. The couples match CAN and WILL work for you pre-interview if you play your cards right, i.e. the stronger partner will pull along the weaker one. And, interviews IMO were rarely if ever focused on the couples aspect, although they frequently started with that fact (on ERAS it's right at the top near your address).

 

[martinD28]

Thank you for the input.

A reasonable consensus I've heard from reiterates fakin' the funk's post. It seems logical that programs would be interested in having two happy people there; however this may be contigent on the departments' willingness to communicate with each other. I do plan on making our relationship known to program directors, if only for the hope of my girlfriend's superior personality helping me/us along.

Spending the first year together will clearly outweigh a transitional year. I am not clear on why we would be more likely to match at the same institution/city if I choose a prelim med year. Is this a reflection of just less TY spots and/or less positions in major cities?

 

[dragonfly99]

I am not clear on why we would be more likely to match at the same institution/city if I choose a prelim med year. Is this a reflection of just less TY spots and/or less positions in major cities?

Getting a medicine prelim spot is likely orders of magnitude easier than getting a TY spot, as there are fewer TY spots and they tend to be sought after by very competitive applicants (high USMLE and grades, going into specialties like rads and ophtho).