A MATCHBREAKER, TOO
interviewer appear to like me? Did this applicant demonstrate sufficient willingness to relocate for this program? Did they smile enough, make eye contact on Zoom, or say the right things to indicate a positive impression?
For those of us who have been through the wringer of app-based dating, it is eerily similar — minus the yearslong contractual obligation.
While the goal of residency match is to maximize results for all applicants and all programs, in reality there are some winners and losers. There are those who match to their top programs, those who do not match at all, and those in the middle — like my childhood friend’s husband, whose match uprooted them both from the eastern U.S. to Idaho after he matched at his eighth-place program, which he later found had ranked him at number 80 out of 120 total candidates.
When both medical students in a relationship are applying in the same cycle, they have two options. The first is the “couples match,” an official and complex process where the couple signs up to create a list of programs together, ranking the most ideal combinations of residency programs for both people — usually combinations of programs that are in the same region.
Mathematically, as one classmate in the couples match explained to me, this entailed ranking more than 100 combinations between him and his partner. Another friend and his fiancée are couples matching but limiting their applications to a single geographic region, allowing them to contend with fewer combinations of outcomes.
To couples match requires great commitment in the relationship; if two applicants are at different levels of competitiveness for their chosen specialties, one partner could be ranked lower at all of their desired programs, reducing the likelihood that both partners can match together at their most highly ranked programs.
Those who choose not to couples match may apply as individuals while coordinating their geographic locations and rank lists in hopes of ending up together without the constraints and complexity of the more official route. This approach allows for more individual freedom but also a greater risk of not ending up in the same region.
This time of year in medical school, tales circulate of past couples who broke up after matching together; or they stayed together, but one partner felt they had given up much more in couples matching than the other. Even though I am not the type of person to sacrifice my entire personal life for my career, I promised myself years ago that I would rank based on what was best for myself and my career, in any relationship short of marriage or engagement.
As my then-partner and I separately went through a winter of interviews, it became clear that his options for residency were limited and all located far away from my preferred programs. We tried to put on a brave face for a while, but his initial optimism turned. In the late winter, about six months after we started dating, our relationship came to a close — amicably and not unexpectedly, though with the standard amount of grief and recovery.
Our relationship was not the first romantic casualty of this year’s residency application cycle, and as we hurtle toward Match Day, I have a feeling that it won’t be the last. Two of my classmates, both applying into surgical specialties, were initially planning to couples match but broke up during the interview season as they realized that the futures they envisioned for themselves and their careers were not in line with one another.
Another friend had been in a relationship with a classmate for years, but they decided not to couples match. She told me months ago that she would be open to staying together only if they matched to programs on the same coast; however, as their rank lists diverged further in location, they recently ended things even before Match Day was upon us.
Still, I remain hopeful for my friends who are still in relationships and plan to make it through Match Day intact. On March 17, when we all open our letters and the fate of our training is sealed, many students’ personal futures will become uncertain or tumultuous — but either way, we will be celebrating a major professional milestone on the road to becoming a physician.