In this episode of Making the Rounds, guests, doctors Michaela Pesce, MD, and Brandon Temel, MD—share their advice for and experience going through the Couples Match.
- Michaela Pesce, MD, first-year obstetrics and gynecology resident, Michigan Medicine
- Brandon Temel, MD, first-year internal medicine resident, Michigan Medicine
- Brendan Murphy, senior news writer, American Medical Association
- Todd Unger, chief experience officer, American Medical Association
Unger: Welcome to Making the Rounds, a podcast by the American Medical Association. In this episode, we continue our “Meet Your Match” series with guests Dr. Michaela Pesce and Dr. Brandon Temel.
Doctors Pesce and Temel, an engaged couple, navigated Match together in their journey to residency and were able to Match at the same program. In today’s episode, they share the logistics and nuance of the Couples Match and what they’ve learned having experienced it firsthand. Here’s AMA senior news writer, Brendan Murphy.
Murphy: Hello and welcome to Meet Your Match on Making the Rounds, a podcast by the American Medical Association. I'm Brendan Murphy, senior news writer at the AMA. Today, we are going to talk about navigating the Match as a couple. Our guests, Dr. Michaela Pesce and Dr. Brandon Temel, will share their experience going through the Couples Match and offer their advice for any future couples going through the process.
Dr. Michaela Pesce is a first-year obstetrics and gynecology resident. Dr. Brandon Temel is a first-year internal medicine resident. They are engaged and both are training at Michigan Medicine in Ann Arbor. Thank you both so much for joining me today.
Dr. Pesce: Thanks so much for having us.
Dr. Temel: It's great to be here.
Murphy: Each year, the number of couples in the Couples Match is somewhere around 1,100. Going through the Match with your partner in mind must have come with some ups and downs for both of you. So we're excited to share your experience with our listeners.
I would first like to begin, if you could maybe describe what your circumstances were and how you opted for the Couples Match.
Dr. Pesce: So we met in our first year of medical school. And we started dating in our second year, already with the knowledge that the Couples Match existed and that if we kept dating, that might be something that we wanted to participate in. And then by our third year, we started thinking about what the Match would look like and decided to apply it as a couple at that point in time. And then from there, we started that application process.
Murphy: That's great, Dr. Pesce. It's probably good for our listeners to have the background. Can you walk us through the mechanics of submitting a Couples Match rank order list? Do you submit separate rank order lists? Is it a combined list? How does that work?
Dr. Temel: So, it's a combined list. And essentially, we both enter it on our own. But they link once it enters the Match. So I'll have my 1 through 10, she'll have her 1 through 10 in that scenario. And if we both wanted to put Michigan at one, we would both put Michigan “one” on our respective lists. And then that basically gets added together in our algorithm.
And if one of us matched our number one but the other one did not, it would go then to the next combination until there was a mutual Match on the same line. And it would continue that way until that happened.
Dr. Pesce: And you can see your partner's list. So you make your own list and they make their own list. But you are coupled in a way that you can say, show my partner's list. And you can see what their number one is. So you make sure that your number one Matches with their number one as well.
Dr. Temel: We double-checked a lot of times to make sure ...
Dr. Pesce: We were very nervous.
Dr. Temel: ... we didn't accidentally put the order in wrong.
Murphy: It does seem to add a layer of complexity.
Murphy You guys are in different specialties. How does that impact this process?
Dr. Temel: I think there's a couple of different variables, especially because the interviews come out at different times. So, it can be a little bit challenging to coordinate because of that. But overall, we were both applying through the same system. So, we were able to link our Matches and things.
So, it was relatively smooth process with our specialties. But there were some differences.
Dr. Pesce: I think as long as you're both applying to specialties that participate in the NRMP Matching program, then it's not so hard. Certainly, a whole other discussion is couples who are wanting to Couples Match but one of them is in a program that doesn't participate in the NRMP like ophthalmology or urology. And unfortunately, the Couples Match isn't possible for them.
But for us, I think the biggest difference was trying to coordinate getting interviews at different times, given that each specialty handles that differently. So for example, OB-GYN has now one interview release date and sometimes a couple trickling days thereafter that they offer interviews. But most programs offer interviews on one day.
Whereas, internal medicine is more of a rolling interview offer process. And it can be really hard to coordinate getting interviews at the same institutions or in the same cities when one person is getting interviews just offered on one day and the other person is getting offers for interviews throughout the season, I think is the biggest challenge when it comes to different specialties.
Murphy: So you would say might be prepared to travel at different times if travel is necessary? Would that be a key point here?
Dr. Pesce: I think that's definitely a big component and used to be a really big player in the interview process before a lot of interviews were virtual. Our interviews were actually all virtual. And I think a lot of them still continue to be virtual.
I think the biggest thing that it really impacted was us trying to actually receive interview offers at the same programs. In the past, when most specialties offered rolling interview offers throughout the season, you had the opportunity to email programs and say, “Hey, I'm participating in the Couples Match, my partner received an interview at your institution, and I'm really interested in interviewing there as well.” And they might still have room to offer you an interview.
Whereas, for us, Brandon might have received an interview offer and my interview offer day had passed already. And it gave those programs less of an opportunity to then offer me one if they had already offered all of their interview slots on that one day that had already passed.
Murphy: Looking at what might be the first step of this process, did you deliberately apply to the same institutions?
Dr. Temel: We did. When we were looking at which programs to apply to, we looked both at the same institutions but also at the same cities. So, we started by targeting cities that would have multiple programs, so we could try to coordinate in the same area and then applying to the same programs as well.
Murphy: But you matched at Michigan, which doesn't have another massive health system in the town, am I right?
Dr. Temel: That's true. Yeah. It worked out that we, thankfully, both had interviews here at Michigan and ended up really liking the program. And I think going into it, we were expecting more so just with the odds of matching and having to match together that we would be ending up at a large city with multiple health systems. That was kind of our perception of what was most likely to happen going in. But it did turn out a little bit differently for us in the end.
Murphy: So this is a good one for our applicant listeners. We're approaching rank order this time. How did you construct your rank order list as a couple?
Dr. Temel: So, there were a couple of different aspects that we looked at when formulating our list. The one being the location and making sure that we were picking programs that were either the same program or in the same area. Looking at strong programs that we felt would allow us to have the training opportunities that we needed. Looking at programs where we felt that it was a good fit and programs that acknowledged us in the Couples Match and made efforts to at least tell us the information and the things that they had in place to help us succeed as a couple in terms of matching up vacations and matching up schedules as best they can, knowing that we're both going to be very busy.
So I think first and foremost, trying to be in the same area, trying to be at the strongest program that we could to allow us to have all those fellowship opportunities that we wanted. And then also programs that made an effort to acknowledge us, both individually and as a couple, really felt good and really steered us towards those programs.
Dr. Pesce: I think for our first 10 or so programs in terms of how we started to rank our programs together, we were able to match up programs that were in the same city as each other or very close by that we both really liked and would have been happy to go to. As we got further down the list, we had to end up deciding whether to prioritize being close to each other versus being at programs that each of us really liked and really wanted to be at which is certainly the hardest part of making that ranked list. But I would say for us, we generally prioritize being in the same city or at the same program.
Murphy: Were there circumstances where one of you really liked a program and one of you really didn't? And how did that factor into this whole process?
Dr. Temel: There were a couple of those circumstances that we had. And one of them that I'm thinking about, I had other interviews in the same area. And so, we talked about being in that scenario in the same city but not necessarily the same program.
And there were a couple of others along the way where one of us had a good interview and the other one felt like it wasn't a program that they would have liked the most. And I think it did play into it somewhat, because picking this process and us deciding to go through with the Couples Match, we underwent this process with the understanding that we're … this is for both of us. And we need to find a compromise and be somewhere where we're both happy and both have an opportunity to be successful.
And so it was definitely a work in progress along the way as we interviewed. But there were certainly some scenarios in which that was the case.
Murphy: How did the results work out for you? Where on your list did you guys match?
Dr. Pesce: We were very lucky to Match at our first-ranked combination. That was—we had a lot of discussions about what to rank first, and second and third. But ultimately, we were so, so excited to match at our number one program which was the University of Michigan.
So we got incredibly lucky. And many happy tears were shed on that day when we found that out.
Murphy: With the wisdom of a year or so in residency training and having been through the Match process, is there anything you would have done differently about this process?
Dr. Temel: I don't think there were any big changes or things that we would do differently on a large scale. I think it was something that we talked about with each other a lot. We knew what our expectations were and what we were looking for in programs. And I think it just took a lot of conversation along the way.
We were constantly discussing and constantly considering as we went to try to pick what options were best for the both of us. And I think that we did that. And I think we were very happy with the results and feel like we ended up at a place that achieved all of the things that we were looking for.
I think there were some conversations about making the rank list as we got into the lower numbers, where maybe we were perseverating or talking too much about particular combinations. Once we got down into the 40s and 50s of the combinations that those conversations and some of that stress may not have been worth it in the end. But it was something that I think, overall, we were happy with the process and how it went. And I don't think we would have made any big changes.
Dr. Pesce: I think one thing that we felt like over time, we could have maybe done a little bit sooner is we could have been a little bit less afraid to email program directors along the way and say, “Hey, I'm participating in the Couples Match, I haven't gotten an interview at your program yet, but my partner has and I would really love that opportunity.” I think there's no harm in doing that.
And certainly, as a single person applying to the Match, not in the Couples Match, you don't have a great deal of excuse to email a program director. I do think you have a lot of reason to do so when you're in a couple. And I think it's really important to take advantage of that.
It doesn't always work. It's not always helpful. But I do think we had a few scenarios in which one or the other of us got an interview because we essentially asked for one. And we made it clear that we really were interested in that program.
So I would say that's something we wish we did sooner because at the end, we had some small benefits from that. But I think perhaps we could have benefited from that if we did it a little bit more in the beginning of the process.
Dr. Temel: I agree. And I think it's always intimidating, especially to reach out to a program director at a program. But I think the thing that we think about is we want to be at a program where we feel like our program director and the faculty there cares about that process. And I think those program directors of those programs that are receptive to that type of communication are the programs that are going to support you as a couple moving forward. So, I think I agree. That's something we could have done a little bit more proactively or sooner in the process.
Murphy: That is an interesting divergence from the typical Match process you often hear to be a little reserved in reaching out to programs or follow their directives after the interview. But you guys were more proactive. You also mentioned, Dr. Temel, the stress of going through the Couples Match and considering the possibilities.
I think it's important to point out that the Match rate for couples which is about 4% or 5% of applicants in a given Match pool is generally the same as it usually is for USMDs. In 2021, for instance, it was 95% which is right around what the Match was for USMDs. Considering all that, do you have any words of encouragement for students in the Couples Match? This might be kind of the stressful period of that whole process.
Dr. Pesce: I think in general, things have a way of working out. And just like they have a way of tending to work out in the regular Match, I think in the Couples Match the same applies. I would say, overall, probably the biggest piece of encouragement and advice is while it's certainly important to focus on what combinations would be best for you as a couple, I think as you make your way down your list and you start to get to those numbers that are more in the 30s, 40s and 50s, however long your list ends up being, I think that it's really important to remember that once you get to that point in the list, just try to think quickly about what is the best combination for you and move on because there's no point in perseverating over that point in the list, where once you're at Match day, you're not going to remember combination number 31 versus 32. You're just going to be really happy that you both matched at a program. And you're going to end up doing your best way to find the good and whatever match that you got.
And so I think that it's really important to remember to enjoy the process as much as possible although it's stressful and know that it's a really great thing that the Couples Match even exists. And I think it can be a really positive and a fun thing ultimately and not to get too bogged down with all the details of it particularly once you get towards that end of the list. And again, some people's lists may be very, very long. I'll be candid that our list was 81 combinations. Some people will rank into the 300s in terms of their combination.
So however long you're at list ends up being, don't get too, too stressed about each little combo.
Murphy: Dr. Temel, do you have anything to add?
Dr. Temel: I agree. I think what we referenced before, there's a lot of parts of the Match ranking list that we perseverate about. But like you said, the Match numbers are good. And they're reassuring and in all likelihood you both people are going to Match, both people are going to be able to pursue their careers that they want to pursue. It just adds a little bit of stress along the way. But I think thinking about that end goal and knowing that the odds of ending up, being able to pursue what you want to pursue in the Couples Match as well are high and just to think about that.
Dr. Temel: I think one piece of advice that would have been helpful starting the process is it can be intimidating and it can be challenging having to advocate not only for yourself but in the Couples Match process, you're also advocating for each other. And something that people say is, as we mentioned before, is emailing program directors and emailing programs, trying to advocate for each other.
But what I actually found to be the most helpful was actually bringing that up in the interview itself and being able to have a conversation with the program director or with an interviewer to let them know that you're participating in the Couples Match, and that's something that's important to you, and really gauging their response to that and letting them face to face that that's something that you're doing. I found that to be the most helpful way to help advocate for Michaela and vice versa when she was on interviews.
Murphy: Dr. Temel, Dr. Pesce, thank you so much for joining us on this episode of “Meet Your Match” on Making the Rounds.
Dr. Pesce: Absolutely. It was a pleasure.
Dr. Temel: Thank you for having us.
Murphy: I'm AMA senior news writer Brendan Murphy. We'll see you next time.
Unger: You can subscribe to Making the Rounds and other great AMA podcasts anywhere you listen to yours or visit ama-assn.org/podcasts. Thanks for listening.
Disclaimer: The viewpoints expressed in this podcast are those of the participants and/or do not necessarily reflect the views and policies of the AMA.