Couples Match Shennanigans?

[gratefulgas]

Hi everyone.
Forgive me for this post being non-specific to IM, but I thought it might be relevant to a number of users here.

My partner and I are participating in the couples match. We've decided that, while we'd obviously like to match somewhere together, we'd rather both match in separate locations than have one of us go unmatched. So what we've done is basically engineered a non-couples match list at the end of our couples match list as a contingency plan for the unlikely event that we fail to match together geographically. We did this by creating our normal couples match list, with all of our paired programs in the same geographical area. This amounted to about 30 rank positions with combinations of programs in the same area. We then each chose our top 10 programs to match at in the "non-couples match." I ranked my top 10 programs, in order, and repeated that list 10 times at the end of our "couples match list." This comprised 100 rank positions. Then, for each of my 10 repeating lists of my top ten programs, my partner entered one program, and did so in order of preference. So #1 was listed 10 times, then #2 ten times, and so on.

In the couples match, you pay based on the number of unique programs, but you have unlimited rank positions, so this does not cost anything extra.

Surely someone must have thought of this and done this before, but I haven't found any mention of this idea! Has anyone met couples who have tried this? Does this make sense, and am I breaking any rules by doing this? Am I missing something that would make this untenable?

Thanks. I hope this idea helps someone else.

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[Raryn]

Hi everyone.
Forgive me for this post being non-specific to IM, but I thought it might be relevant to a number of users here.

My partner and I are participating in the couples match. We've decided that, while we'd obviously like to match somewhere together, we'd rather both match in separate locations than have one of us go unmatched. So what we've done is basically engineered a non-couples match list at the end of our couples match list as a contingency plan for the unlikely event that we fail to match together geographically. We did this by creating our normal couples match list, with all of our paired programs in the same geographical area. This amounted to about 30 rank positions with combinations of programs in the same area. We then each chose our top 10 programs to match at in the "non-couples match." I ranked my top 10 programs, in order, and repeated that list 10 times at the end of our "couples match list." This comprised 100 rank positions. Then, for each of my 10 repeating lists of my top ten programs, my partner entered one program, and did so in order of preference. So #1 was listed 10 times, then #2 ten times, and so on.

In the couples match, you pay based on the number of unique programs, but you have unlimited rank positions, so this does not cost anything extra.

Surely someone must have thought of this and done this before, but I haven't found any mention of this idea! Has anyone met couples who have tried this? Does this make sense, and am I breaking any rules by doing this? Am I missing something that would make this untenable?

Thanks. I hope this idea helps someone else.

You are not breaking any rules. You are doing the absolute correct thing based on your priorities. Don't forget to also rank (at the very bottom) the combinations of one person matched and the other unmatched. The code for that is all 9s.

Basically, and we've gone over this in the eras/match forum a bunch of times, for the couples match the number of possible ranks is equal to the number of interviews (+1) for one partner multiplied by the number of interviews (+1) for the other partner, minus one (you don't rank the possibility that you both go unmatched).

Thus, if one partner has 8 interviews and the other partner has 10 interviews, you can rank up to (9*11)-1= 98 possibilities. Some of these will be combinations where you get your top choices in the same spot. Some of these will be top choices far apart. Some of these will be one person in a top choice but the other will be in a less than ideal choice in the same location. And 18 of them (at the end) will be one person going completely unmatched. You will have have to decide the order of all these combinations and you will have to decide if any of them are so bad you'd rather one of you go unmatched.

 

[gutonc]

Surely someone must have thought of this and done this before, but I haven't found any mention of this idea! Has anyone met couples who have tried this? Does this make sense, and am I breaking any rules by doing this? Am I missing something that would make this untenable?

Thanks. I hope this idea helps someone else.

Everyone who has ever done the couples match with even a trace of a clue of how the match works has done it this way. The others are idiots.

 

[obiwan]

good luck. going through the couples match was a b*t*h

 

[Raryn]

Like I said, I've never heard anyone mention this strategy. Maybe a lot of people would prefer to have one person go unmatched rather than match in separate cities, though I agree this is a bit crazy after 4 hard-fought years of med school. The software certainly doesn't make it easy to employ this strategy since you need to enter the program codes one at a time, ctrl-v over and over and over potentially hundreds of times depending on the number of programs. You'd think they would make it easier.....wait.....no......scratch that.

Anyway thanks for confirming that this is the way to go.

I would suggest making an excel spreadsheet with all the permutations, then making your rank list in there by moving stuff around. Best way to make sure no combinations are missed.

After that, it's trivial to copy paste the codes from excel to the NRMP site in order, then cross check your respective lists against your spreadsheet.

(Never couples matched myself, but helped out people who had)

 

[OneoftheGuptas]

My fiance and I are both applying into the same field, and decided not to couple's match, since it seemed to be an added complication (we are both IMGs with average scores). Some of the programs are large, with 20-25 PGY-1s, and others are smaller with 6-10 PGY-1s.

However, after reading this thread, I'm almost wondering if the combined rank list with all its permutations can actually increase our chances of matching? Statistics is not my strong suit, so any clarification would be helpful! I have 8 interviews with 9 possible ranks (2 tracks within the same program), and he has 7 interviews with 8 possible ranks (for the same reason). Based on the formula Raryn mentions, we should be having 89 combinations in our ROL.

Thus far, we have gone on many of the same interviews and informed programs that we are not matching as a couple. I'm not sure if it would work for or against us if we changed our minds (I assume we'd have to inform programs of the update). A post made by Raryn a few years ago implied that programs don't have to know, because we can simply leave the box in ERAS unchecked.

 

[thehundredthone]

However, after reading this thread, I'm almost wondering if the combined rank list with all its permutations can actually increase our chances of matching? Statistics is not my strong suit, so any clarification would be helpful!

Nope. Your rank list regardless of its permutations will not change the programs' rank list. What the couple's match list allows you to do (what its intent is, anyway) is define your geographical priorities. So while you would have more control over the possible program combinations and an otherwise lower ranked program may rise higher in the list due to the permutations, you will not increase your chances of matching at any of the programs.

 

[legendaryjon2413]

My fiance and I are both applying into the same field, and decided not to couple's match, since it seemed to be an added complication (we are both IMGs with average scores). Some of the programs are large, with 20-25 PGY-1s, and others are smaller with 6-10 PGY-1s.

However, after reading this thread, I'm almost wondering if the combined rank list with all its permutations can actually increase our chances of matching? Statistics is not my strong suit, so any clarification would be helpful! I have 8 interviews with 9 possible ranks (2 tracks within the same program), and he has 7 interviews with 8 possible ranks (for the same reason). Based on the formula Raryn mentions, we should be having 89 combinations in our ROL.

Thus far, we have gone on many of the same interviews and informed programs that we are not matching as a couple. I'm not sure if it would work for or against us if we changed our minds (I assume we'd have to inform programs of the update). A post made by Raryn a few years ago implied that programs don't have to know, because we can simply leave the box in ERAS unchecked.

Programs don't have to know you're couple's matching if you left the box unchecked. In terms of increasing chances of matching, the Couple's Match can increase your chances of matching together, like the above poster said, if you move lower coupled ranks up your combined list. But overall, doing the Couple's Match properly will not increase/decrease your chances vs. individual lists.

 

[Raryn]

My fiance and I are both applying into the same field, and decided not to couple's match, since it seemed to be an added complication (we are both IMGs with average scores). Some of the programs are large, with 20-25 PGY-1s, and others are smaller with 6-10 PGY-1s.

However, after reading this thread, I'm almost wondering if the combined rank list with all its permutations can actually increase our chances of matching? Statistics is not my strong suit, so any clarification would be helpful! I have 8 interviews with 9 possible ranks (2 tracks within the same program), and he has 7 interviews with 8 possible ranks (for the same reason). Based on the formula Raryn mentions, we should be having 89 combinations in our ROL.

Thus far, we have gone on many of the same interviews and informed programs that we are not matching as a couple. I'm not sure if it would work for or against us if we changed our minds (I assume we'd have to inform programs of the update). A post made by Raryn a few years ago implied that programs don't have to know, because we can simply leave the box in ERAS unchecked.

Two points here

1) You can couples match without letting the programs know you are couples matching. They can't ask you about your significant others, and you can leave the couples field on ERAS blank while couples matching on the NRMP site. It's completely allowed and if you think that programs would dislike you couples matching, you can avoid that possibility. The programs have no way to see one way or the other.

2) The best you can do if you ranked all 89 permutations is to have individual matching chances identical to what they would otherwise be. There's no way to get them to be greater than they would otherwise be, because that wouldn't make any sense. Couples matching like that takes away any disadvantage that you think you might get from it.

 

[OneoftheGuptas]

Thank you so much for these explanations!! I read the posts describing how to rank for couples match so many times, I dreamt about ROLs the entire night.

Up until now, I was always thinking that Couples Matching would work AGAINST us. Now, though, I see that as long as I am smart about ranking every possible permutation (according to preference, of course), that will not be the case. If I'm going to have the same odds of matching, I might as well go the route that increases the chances of matching closer to my fiance! I feel like doing cartwheels. Seriously.

Also, thank you for letting me know that programs don't have to be informed of the update. This would have been a major factor holding us back.
Thank you, once again!!

 

[iniquus]

Up until now, I was always thinking that Couples Matching would work AGAINST us. Now, though, I see that as long as I am smart about ranking every possible permutation (according to preference, of course), that will not be the case. If I'm going to have the same odds of matching, I might as well go the route that increases the chances of matching closer to my fiance! I feel like doing cartwheels. Seriously.

Couples matching shouldn't work against you if you execute the algorithm correctly. That's what people say and it's true to a certain extent. Making the incorrect assumption that your individual ROL and your couple's match list are identical for the sake of an example, you can at best match to what you would have individually. Dropping down your individual list is also a probability.

If you declare you're couple's matching on your application and programs know that you two are a package deal, it theoretically could count against you when programs make their ROL. This is the price you pay to make geography sync up.

 

[J-Bongo22]

I couple's matched last year successfully. We ended up on the bottom half of the combinations that allowed us to live together (me at #5 on my individual list and him at his #8). But keep in mind that both of had programs that we had ranked higher on our individual lists but were ranked lower on our actual rank list because we wouldn't have been able to live together. I got emails from programs that I had ranked higher than the program I matched at after match day telling me how disappointed they were that I did not appear on their match list. My experience so far in intern year has been that having my fiancé around has been far more important in my success than being at any of those other programs. If you think you may feel the same way then couple match!

 

[OneoftheGuptas]

Iniquus, both of us have the same programs listed in our top 4, and so we will use those same programs at the top of our matched ROL. Though the chances of actually matching into the same program may be slim, it's worth a shot. Unfortunately, anything outside those 4 drops us way down on our individual lists and at least 2.5 hours apart, if not opposite ends of the country.

J-Bongo, thank you for echoing my sentiments!! I'm so happy to hear that you were able to match as a couple, it must have been such a thrilling moment for you to find out. I'm also very happy to hear that you are satisfied both professionally and at home, though you both did not end up at your top choice programs! One of our top choices is a new program, which obviously comes with some drawbacks. However, having my best friend/fiance around trumps that!

 

[FranzLO]

Hey I am a little confused about this, and I will likely go the couples match route. Anyone know of any good posts on here in addition (can't find them) or can you give an example? Thanks! I think I almost get it, but having trouble picturing the strategy.

 

[legendaryjon2413]

Hey I am a little confused about this, and I will likely go the couples match route. Anyone know of any good posts on here in addition (can't find them) or can you give an example? Thanks! I think I almost get it, but having trouble picturing the strategy.

If by strategy you mean couples match, just google it and you can find a good example showing how the couple's match works step by step. If by strategy you mean ranking, there's many ways to go about it. Most people put all the coupled ranks on top and mix after that.

 

[iniquus]

Hey I am a little confused about this, and I will likely go the couples match route. Anyone know of any good posts on here in addition (can't find them) or can you give an example? Thanks! I think I almost get it, but having trouble picturing the strategy.

There's no strategy. You can't game the individual or the couple's match. In simple terms, the algorithm tentatively matches you to your highest ranked program if that program also ranks you. If more people want that program as well and are ranked higher than you by said program, then you will fall to your next choice...and the process repeats. In a couple's match, both lists are run parallel to each other and both of you must "match" to the program in order for the decision to be finalized.

Let's say you and your SO make your list together. One of you matches to your joint #1 (same program or not), but the other one doesn't, then you will both fall to your second choice. This is why you can fall down your couple's list more rapidly than you would have if you had run the match as one person. There are probably some programs who like couples within their own residency (might be more stable support system, happy residents), some that don't want a couple in the same program (source of potential drama or distraction, scheduling conflicts), or a few who coordinate with neighboring programs (don't want to take them both, but this is a big city with many programs, so they'll be okay). If you declare couple's match and that program is the only great program in that city/state, then the program can safely assume you two are a package deal and will rank you accordingly. This is all the risk you take to sync your geography for the couple's match--it's better to be together at a lower ranked program than alone and long-distance at a higher ranked program.

You choose the combinations, you can rank different city programs over same city programs if you feel you'd be happier at two separate institutions. You can rank situations where one of you matches and the other doesn't near the bottom of your list. The permutations are boggling and in a perfect world, if you didn't declare it on ERAS, it should not affect your chance at matching (although it can hurt you in terms of where you fall on the ROL).

 

[FranzLO]

Thank you for responses

Hi everyone.
Forgive me for this post being non-specific to IM, but I thought it might be relevant to a number of users here.

My partner and I are participating in the couples match. We've decided that, while we'd obviously like to match somewhere together, we'd rather both match in separate locations than have one of us go unmatched. So what we've done is basically engineered a non-couples match list at the end of our couples match list as a contingency plan for the unlikely event that we fail to match together geographically. We did this by creating our normal couples match list, with all of our paired programs in the same geographical area. This amounted to about 30 rank positions with combinations of programs in the same area. We then each chose our top 10 programs to match at in the "non-couples match." I ranked my top 10 programs, in order, and repeated that list 10 times at the end of our "couples match list." This comprised 100 rank positions. Then, for each of my 10 repeating lists of my top ten programs, my partner entered one program, and did so in order of preference. So #1 was listed 10 times, then #2 ten times, and so on.

In the couples match, you pay based on the number of unique programs, but you have unlimited rank positions, so this does not cost anything extra.

Surely someone must have thought of this and done this before, but I haven't found any mention of this idea! Has anyone met couples who have tried this? Does this make sense, and am I breaking any rules by doing this? Am I missing something that would make this untenable?

Thanks. I hope this idea helps someone else.

Thank you for the responses to my question, but I am more confused about this strategy. I know a little about the couples match but for some reason when I read this, it is not clicking in my brain what exactly this is or how it helps haha.

 

[Raryn]

Thank you for responses


Thank you for the responses to my question, but I am more confused about this strategy. I know a little about the couples match but for some reason when I read this, it is not clicking in my brain what exactly this is or how it helps haha.

The strategy is simple.

Lets say that you have four ranks (A, B, C, and D) and your partner also has four ranks (1, 2, 3, 4). There are 24 possible ranking combinations for you two, taking into account the option of not matching (X). If you just permutate all combinations you get:

A1
A2
A3
A4
B1
B2
B3
B4
C1
C2
C3
C4
D1
D2
D3
D4
X1
X2
X3
X4
AX
BX
CX
DX

That is the list of all possible combinations. If you rank that entire list (in whatever order you prefer, putting the only one person matching options at the end), the couples match mathematically cannot be a disadvantage. You will each have the same individual chance matching that you would have had on your own. If there's any combinations that you DON'T rank, one of you will have a potential disadvantage. Lets say that you make your rank list and decide not to rank D4, stating that it is your last choice for both of you and you're far away. You'd rather rank the combinations with one of you unmatched instead of it. That's fine, but that's one less chance for you both to have a residency.

To make your rank list, I think the easiest thing would be to open an excel spreadsheet and create a list of all combinations. This could very easily be >100 combinations (given that I doubt you both have only 4 ranks). Then start cut and pasting them to rearrange them into an appropriate order. At the top are where you're both at one of your top choices and you are in a similar location. Then you have to decide your priorities (i.e. your top choices, your partners top choices, and same location), because there will be a number of combinations that fit 2/3 criteria only. Then 1/3 criteria only. Then 0/3 criteria (like D4 earlier). Do you have to rank them all? No. Just understand what that means: You would prefer one partner be unmatched rather than get that combination.

Then, at the bottom, you put in all the combinations where either partner is completely unmatched. This is absolutely key. Because if you don't do that, the only thing the computer can do if you get to the bottom of the list is make you *both* unmatched. Which partner goes first here doesn't actually matter, because, having failed all of the above combinations, one of them would have gone unmatched regardless. You don't know which though, so you want to make sure to rank everything there.

 

[Gubernaculum13]

good luck. going through the couples match was a b*t*h

can you elaborate? What happened in your situation (i.e. how big of a bi**)?

 

[obiwan]

can you elaborate? What happened in your situation (i.e. how big of a bi**)?

Well, it just sucked because you had to take so much more into account when coming up with your rank list. If I had singles matched, my list would have been quite a bit different but because I was a stronger applicant than my significant other, our list was a compromise where we thought that we had a higher chance of matching into the same program or programs in same city. you also have to consider are you willing to have a "successful" match but you and s/o could end up in different cities rather than not matching at all and having to scramble. we were able to get our #1 choice

 

[drk]

I've got about 500 combinations with my partner. The first 30-40 were fairly easy but after that it was a pain in the butt. Glad it worked out for you obiwan.

 

[legendaryjon2413]

I've got about 500 combinations with my partner. The first 30-40 were fairly easy but after that it was a pain in the butt. Glad it worked out for you obiwan.

Jeez, and I thought my 300+ were too much..

 

[NotAProgDirector]

Hey I am a little confused about this, and I will likely go the couples match route. Anyone know of any good posts on here in addition (can't find them) or can you give an example? Thanks! I think I almost get it, but having trouble picturing the strategy.

Check this thread out: http://forums.studentdoctor.net/threads/couples-match-algorithm-help-for-rol.604622/

Especially post #11 onwards (since the earlier posts have some inaccurate information in it)

 

[FranzLO]

Check this thread out: http://forums.studentdoctor.net/threads/couples-match-algorithm-help-for-rol.604622/

Especially post #11 onwards (since the earlier posts have some inaccurate information in it)

Cool thanks! Very helpful.

 

[bbg1951]

so I was just discussing this earlier but suppose you are couples matching and you have ranked not matching if your partner matches at a particual institution. If they match there, can you still participate in soap or are you considered matched since you ranked to go unmatched if they matched at that institution?

 

[ThoracicGuy]

so I was just discussing this earlier but suppose you are couples matching and you have ranked not matching if your partner matches at a particual institution. If they match there, can you still participate in soap or are you considered matched since you ranked to go unmatched if they matched at that institution?

You are not matched. Your partner is.

 

[drk]

I'm pretty sure you get to SOAP. Also, I believe I read somewhere that it's possible to call NRMP and get your partner's match location so you can SOAP accordingly. That second part may have been rumor though. Hopefully it doesn't come to that.

 

[Raryn]

I'm pretty sure you get to SOAP. Also, I believe I read somewhere that it's possible to call NRMP and get your partner's match location so you can SOAP accordingly. That second part may have been rumor though. Hopefully it doesn't come to that.

It's true. You'll be able to call and get the results for the other party on Match Monday (4 days before you'd otherwise know) if you are either partially matched (advanced or prelim) or if you are partially couples matched. Your dean may also have a list.

 

[gutonc]

Aren't they weirdly sketchy about it? Like they won't actually tell you the other party's match, just what city it is in?

Yes, they'll tell you the city. I don't think that's "weirdly sketchy" so much as trying to maintain the integrity of the process.

 

[OneoftheGuptas]

so I was just discussing this earlier but suppose you are couples matching and you have ranked not matching if your partner matches at a particual institution. If they match there, can you still participate in soap or are you considered matched since you ranked to go unmatched if they matched at that institution?

Here ya go!

http://www.nrmp.org/wp-content/uploads/2015/01/SOAP-FAQ-Applicants_FINAL.pdf

 

[Dactino]

Hey so after reading this im a little confused. My fiance and I are applying for the match but since we are both IMGs i dont know if it is a good idea if we declare we are a couple on eras. By that it mean ticking on the box where it says you are planning to apply for couples NRMP match right? So if we decide not to couple match on eras we can still do ROL as a couple after the interviews????

 

[NotAProgDirector]

Hey so after reading this im a little confused. My fiance and I are applying for the match but since we are both IMGs i dont know if it is a good idea if we declare we are a couple on eras. By that it mean ticking on the box where it says you are planning to apply for couples NRMP match right? So if we decide not to couple match on eras we can still do ROL as a couple after the interviews????

Yes. ERAS and NRMP are completely separate. You can either declare in ERAS that you are couples matching, or you can "stealth" couples match by not mentioning it in ERAS, applying, and then using the couples match in NRMP. Programs will not be able to tell.

 

[jchil7]

I was wondering if I could get some advice/ opinions from you guys/girls. So my GF and I are both 4th year medical students. She is applying ENT and I am applying IM and planning to go into Cardio fellowship after. We really want to stay together after the match. So far so good. However, now that we have all our interviews scheduled there is a problem. She has 6 total ENT interviews. Two interviews are at places in states that I didn't even think to apply to, two more are isolated but I knew she did away rotations there so I interviewed at both, however, when I made my rank list both of these place fell at dead last, the one I know for a fact I'd be miserable there.

So I'm stuck. We both worked really hard for this so I don't expect her to just not rank the places that I can't match. Conversely, knowing that in three years I have to match a competitive fellowship, I don't think it's fair that I follow her to what are my lowest two programs and to programs I think would be detrimental to matching in cardio later on in an area I want to train.

We've been together 3+ years at this point. I am definitely going into cardio, I highly highly doubt I will feel differently in residency, so assume I am doing cardio after.

Here are the places I interviewed at Grouped by places I liked the most/ thought would set me up for the future well:

Favorites:
Brown
BID
Temple
Univ of Maryland
Dartmouth
Jefferson
Next tier:
Penn State
VCU
Robert wood johnson
Next tier down:
MUSC
Virginia tech
Cooper hosp
Penn Hosp
The other places she had an interview (and at my bottom)
Geissinger
Louisville

 

[IMreshopeful]

I was wondering if I could get some advice/ opinions from you guys/girls. So my GF and I are both 4th year medical students. She is applying ENT and I am applying IM and planning to go into Cardio fellowship after. We really want to stay together after the match. So far so good. However, now that we have all our interviews scheduled there is a problem. She has 6 total ENT interviews. Two interviews are at places in states that I didn't even think to apply to, two more are isolated but I knew she did away rotations there so I interviewed at both, however, when I made my rank list both of these place fell at dead last, the one I know for a fact I'd be miserable there.

So I'm stuck. We both worked really hard for this so I don't expect her to just not rank the places that I can't match. Conversely, knowing that in three years I have to match a competitive fellowship, I don't think it's fair that I follow her to what are my lowest two programs and to programs I think would be detrimental to matching in cardio later on in an area I want to train.

We've been together 3+ years at this point. I am definitely going into cardio, I highly highly doubt I will feel differently in residency, so assume I am doing cardio after.

Here are the places I interviewed at Grouped by places I liked the most/ thought would set me up for the future well:

Favorites:
Brown
BID
Temple
Univ of Maryland
Dartmouth
Jefferson
Next tier:
Penn State
VCU
Robert wood johnson
Next tier down:
MUSC
Virginia tech
Cooper hosp
Penn Hosp
The other places she had an interview (and at my bottom)
Geissinger
Louisville

All the places in your favorites and next tier will do a good job at helping you match cardiology and are in decent locations. Dartmouth is a bit isolated location wise but still pretty nice.

The next tier down places are all also okay - the only thing is that VT is pretty isolated and the residency perhaps not as strong. Pennsy is a weaker Philly residency but still not bad.

Geisinger is actually pretty decent community program but def not as good as the others you have listed. Don’t know much about Louisville.

I would think about this and talk it over with your girlfriend. It depends on your priorities. Also perhaps try to cluster some places by location as well as the same program. It’s a hard choice.

 

[rokshana]

I was wondering if I could get some advice/ opinions from you guys/girls. So my GF and I are both 4th year medical students. She is applying ENT and I am applying IM and planning to go into Cardio fellowship after. We really want to stay together after the match. So far so good. However, now that we have all our interviews scheduled there is a problem. She has 6 total ENT interviews. Two interviews are at places in states that I didn't even think to apply to, two more are isolated but I knew she did away rotations there so I interviewed at both, however, when I made my rank list both of these place fell at dead last, the one I know for a fact I'd be miserable there.

So I'm stuck. We both worked really hard for this so I don't expect her to just not rank the places that I can't match. Conversely, knowing that in three years I have to match a competitive fellowship, I don't think it's fair that I follow her to what are my lowest two programs and to programs I think would be detrimental to matching in cardio later on in an area I want to train.

We've been together 3+ years at this point. I am definitely going into cardio, I highly highly doubt I will feel differently in residency, so assume I am doing cardio after.

Here are the places I interviewed at Grouped by places I liked the most/ thought would set me up for the future well:

Favorites:
Brown
BID
Temple
Univ of Maryland
Dartmouth
Jefferson
Next tier:
Penn State
VCU
Robert wood johnson
Next tier down:
MUSC
Virginia tech
Cooper hosp
Penn Hosp
The other places she had an interview (and at my bottom)
Geissinger
Louisville

have you asked the places that interviewed you to see if she could get an interview there?
have you interviewed at the 6 places she has had interviews?

are you planning on getting married ...meaning you have a ring and plan on giving it to her before graduation?
can your relationship survive the long distance or are you willing to find out?

Brown, BID, and Dartmouth allow ya'll to be close enough to each other since they are maybe 1-1.5 hours away form each other (and Cape Air has cheap flights from Lebanon to Boston and the Acela goes between Bos and providence)...providence to Lebanon would the longest and its still maybe 3 hours apart.

Temple, Jeff, Cooper, and Penn are obviously near each other and Penn State and RWJ are again close enough , maybe 2 hours from philly? that the distance wouldn't be horrible.