Having gone through the couples match a couple of years ago, here are thoughts based on my experiences. As one poster above mentioned, there is no one answer, but I think that understanding and thinking through the process a bit will help you make decisions for yourself. Ill try to keep it brief, but its a lot to think about.
The first thing you need to understand is how the couples match works. While solo applicants rank programs, couples rank permutations of programs:
1. John Medicine at NYU, Susan Derm at NYU
2. John Medicine at NYU, Susan Derm at Cornell
3. John Medicine at Cornell, Susan Derm at Cornell
4. John Medicine at Cornell, Susan Derm at NYU
5. John Medicine at UCLA, Susan Derm at UCLA
6. John Medicine at UCLA, Susan Derm at USC
7. John Medicine at UCLA, Susan Derm at NYU
8. John doesnt match, Susan Derm at NYU
9. John Sugery at NYU, Susan Derm at NYU
And so on in a seemingly endless fashion with any permutation of programs you can come up with and are willing to endure. Notice that you can choose to be willing to match in separate cities, and you can choose to have one person not match. Thats a pretty simplified view, but when I was in your position, I didnt even understand that much. Just so youre aware, you are charged per program when you make the rank list, not permutation, so you can make as many permutations as you would like to without incurring a financial penalty.
You mentioned the weakness being the board score, but the specialty being applied to is also relevant. Is it a weak board score applying to something competitive like neurosurgery, or something less competitive like family medicine? It makes a difference.
As mentioned in earlier posts, it also makes a difference whether or not you are applying to the same specialty. I think applying to the same specialty makes things more difficult for the simple reason that if I were a PD, I would not want a couple in the same class in my program because of potential problems down the road. It wouldnt be a problem if you were at different programs in the same city, but when you do that youre effectively decreasing the number of programs/positions that are available to you, which decreases your odds. Having said that, Im not a PD, and there are probably PDs out there who dont have a problem with couples in their residency classes. My best guess is that the majority dont.
If youre in different specialties, programs within the same institution can and do talk to each other. They are not obligated to, and not all do, but I guarantee that some do. I dont know how much influence that has, and Im sure it varies between institutions and programs.
Back to the original question:
I think people are answering the same question in different ways, which makes this even more confusing, so Im going to break it down into multiple, more specific questions:
1. Does the weaker applicant decrease the stronger applicants chances of being ranked highly?
Probably not. There is no real incentive for the program to rank them lower.
2. Does the stronger applicant increase the weaker applicants chances of being ranked higher?
Maybe, but I think its only going to have a significant impact if the weaker applicant has some intrinsic appeal.
Ultimately those two questions arent really what you care about, what matters in the end is whether or not you will match into that program (or any program). So the questions become:
1. Does the weaker applicant decrease the stronger applicants chances of matching into a given program?
The short answer is Yes because if the weaker applicant cant match into the same region as the stronger candidates program of choice, then the stronger candidate wont match there either, even if they were ranked #1. You can avoid this by listing permutations that allow the two of you to go to programs in different cities, but this defeats the purpose of the match.
2. Does the stronger applicant increase the weaker applicants chances of matching?
Maybe if they were in the grey zone. For example, the positive attention directed towards the weaker applicant may cause them to rank them a couple slots higher, which would help them match there. Its not, however, going to move the weaker applicant from being ranked #47 to #7.
3. Does the stronger applicant decrease the chance of the weaker applicant matching?
Unfortunately, couples matching is just more difficult, and whether your both strong or both weak, your chances are just decreased by the numbers. In theory, you could prevent each other from matching even if you are both strong applicants. Consider this: If partner A matches is only able to match at UCSF, and partner B is only able to match at MGH, but they have not included that permutation in their rank list, neither will match.
So what do you do to have a successful couples match?
1. Apply broadly
2. Focus on cities that have many programs for each of you
3. Be realistic about your chances of matching into a particular specialty. Im not saying you shouldnt try, but if youre trying to get into dermatology and with a Step 1 of 205, you should have a plan B. Talk to your advisor.
4. Consider all possible permutations for your rank list, but only rank the ones you are really willing to do. Participating in the match is a binding contract.
The question of whether or not to tell programs that you are couples matching always come up, so Ill just go ahead and address it. Whatever you do, dont lie, dont bend the truth, and dont be deceitful. You dont have to advertise anything, and I wouldnt tell them that youre couples matching until the interview itself, but dont hide it. If you find yourself watching what youre saying to avoid letting it slip, youre doing yourself a disservice. If youre so involved with somebody that youre doing the couples match with them, they better be a big part of your life, and its going to come out at some point during the interview day. Be yourself and show them who you are. Figure out how to talk about your relationship and convey how positive it is and how it contributes to making you a better doctor and personit shouldnt be all that difficult.
The last thing to remember is that you are not just a board score, and program directors recognize that. Once you have an interview, your foot is in the door, and it is an opportunity to highlight your strengths. The playing field has been leveled, and it is your time to shine.
I hope that was helpful.
Good luck.
