Creating a Match rank-order list requires critical and strategic thinking. Doing so with a romantic partner— balancing two people’s life priorities and career goals—adds a layer of complexity to the process.
Historically, about 1,000–1,500 couples apply to residency programs through the Couples Match. What does it take to find success? In advance of the March 4 deadline for residency applicants to submit and certify their Match rank-order list, data and insights from a resident who has been through the process offer up some key do’s and don’ts.
Do: Start with two lists
Chance Fisher, DO, is a family medicine resident who successfully navigated the Couples Match in 2024 with his wife Alyssa Fisher, DO, DrPH.
As married parents with a 1-year-old child, the Fishers also were both applying to the same specialty, family medicine. That means that, in creating a list as a couple, they were likely to end up at the same program. These circumstances created a different dynamic in which one of them would interview with a program and the other would have to wait days or even weeks to do the same.
Because of that, they kept their impressions to themselves and didn’t even begin to discuss how they were ranking residency programs until interview season was nearing its conclusion.
"If you try to rank as you go along on the front end, you’re going to add stress,” said Dr. Chance Fisher, a family medicine resident in Galveston, Texas. “Doing it individually and then coming together didn’t put pressure on either one of us to perform a certain way in an interview. In the end, waiting to share lists worked really well for us."
Do: Plan to match anywhere
This holds true for both the Couples Match and the Main Residency Match. If you rank a residency program, you must envision life at that program and consider the possibility of matching with it.
A 2025 survey of internal medicine residents that examined outcomes for internal medicine residents who matched as part of a couple versus those that matched individually found that 67% of Couples Match participants matched at one of their top three ranked programs. This rate is significantly lower than that of individual internal medicine applicants in the study’s sample, who matched at one of their top-three choices at a rate of 89%.
Broader 2025 Match data gathered by the National Resident Matching Program (NRMP) shows that among all U.S. MD seniors, 73.2% matched to one of their top three choices, and for DO applicants, the rate was 76.2%.
Don’t: Overlook your support network
Both Dr. Fishers grew up near Houston, and they attended medical school in San Antonio, making proximity to family a major factor in their Couples Match rank-order list. The physician couple initially applied broadly, but ultimately prioritized Texas programs because of family support.
“We had already planned for Alyssa’s mother to go wherever we went for residency and live with us wherever we moved," Dr. Chance Fisher said. “We didn’t want to move her out to Seattle where she didn’t know anybody and had no connections and no family.”
“With our background and support in the area, location trumped everything else for us.”
Don’t: Panic at misalignment
It’s normal for applicants pursuing the Couples Match together to rank programs differently. That first list is just a starting point.
In the study of internal medicine residents, 64% of couples reported needing to make compromises to ensure matching together.
For the list reveal, “we put up both of our rank lists on the big screen TV, then we compared where each program was, which ones were close and which ones lined up," said Dr. Chance Fisher. “We were lucky: Our top 10 were mostly the same.”
When things didn’t align, “we made our case for why one program was ranked higher than another. If one of us had a really bad interview, we factored that in.”
Do: Apply as broadly as possible
When the Fishers created their Couples Match rank-order list, it consisted of 24 programs. All but six were in Texas. Even with staying close to home being a top priority for their family, they wanted to maximize their chances of Matching.
Still, the six out-of-state programs they listed—some as far as California and North Carolina—were the bottom six on their list.
“The biggest challenge would have been moving far with our young daughter and taking Sandy, my mother-in-law with us,” Dr. Chance Fisher said. “It would have been difficult for her, so we really were hoping we didn’t have to [make a big move]. In the end, it would have been a shorter-term time commitment, and we decided we could do it if we all were together.”
Do: Consider individual options
In creating a Couples Match rank-order list, there is an option to rank some contingency programs as an individual. By entering a no-Match code, applicants have the option of one partner indicating a willingness to be unmatched at a specific rank on the rank-order list if the other partner matches to the program paired to that rank.
In essence, couples can create individual rank-order lists as a supplement to their Couples Match list by using these codes. For some couples, matching and making it work long distance is a worthwhile endeavor, but for the Fishers, a scenario where only one matched or they both matched in separate cities was not an option.
“We decided it would be better for us to only rank matching programs where we would end up … able to stay together because of our family, because of our daughter more than anything,” Dr. Chance Fisher said.
Do: Stay positive
Here’s the good news: It generally works out for applicants in the Couples Match.
According to data from the NRMP, “in the 2025 Match, there were 1,259 couples, of which 89.1% (1,122) both matched. There were 102 couples where only one individual matched, bringing the total couples match rate to 93.2 percent and there were 35 couples where neither individual matched.”
The overall Match rate for couples closely mirrored the overall Match rate for applicants from osteopathic (92.6) and allopathic (93.5%) medical schools in 2024.
When the Fishers opened their envelope on Match Day, they found out that they matched with one of their top choices—about 50 miles from Houston.
“We are very happy with where we ended up,” Dr. Chance Fisher said. “Finally having an answer to this instead of a question mark—there was a lot of gratitude in that.”
In advance of Match rank-order list submission, applicants may want to consult FREIDA™, the AMA’s comprehensive residency and fellowship database, which includes more than13,000 Accreditation Council for Graduate Medical Education-accredited residency programs and offers a streamlined user experience.
