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.
Chance Fisher, DO, is a family medicine resident who successfully navigated the Couples Match in 2024 with his wife Alyssa, also a DO. In advance of the March 5 deadline for applicants in the 2025 Match cycle to submit and certify their rank-order list, Dr. Fisher offered a few tips for creating a rank-order list as a couple.
The AMA helps medical students master the residency-application process so you can make the right decisions about your career, prepare for a knockout interview, explore residency opportunities—all so you can successfully match.
Start with two lists
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 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. 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."
Dive deeper:
- Learn the mechanics of the Couples Match
- Meet Your Match: Navigating the Couples Match
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- How making a cross-country move can impact your rank-order list
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.
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. 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.”
Keep personal priorities in mind
Even before interviews, Dr. Fisher and his wife had conversations about what mattered most to both of them. Keeping such priorities in mind will make it easier to see your partner’s vantage point. For the Fishers, finding a program that prepared them for potential fellowships was key.
"For me, I was interested in finding a program that had good sports medicine training,” said Dr. Fisher, an AMA member. “My wife was interested in finding a program that had good ob training, … These were two separate priorities."
Dive deeper:
- Success in residency, romance aren’t exclusive
- 6 tips for balancing a two-physician family
- How to make a long-distance relationship work in physician residency
- Medical student parents factor in family when picking a specialty
- Key match tips for medical student parents
Know your non-negotiables
Both Dr. Fisher and his wife 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. They 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. 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.”
Plan to match at any ranked program
This holds true for both the Couples Match and the Main Residency Match. If you rank a residency program, you have to envision life at that program and consider the possibility of matching with it.
When the Fishers created their Couples Match rank-order list, it consisted of 24 programs. All but six were in Texas. Still, they had to consider the possibility that they might have to leave the Lone Star State. 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. 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."
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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 to be able to stay together because of our family, because of our daughter more than anything,” Dr. Fisher said.
Dive deeper:
- Why doctors marry doctors: Exploring medical marriages
- Success in residency, romance aren’t exclusive
- Meet Your Match”: Composing a rank-order list
- 6 tips for balancing a two-physician family
- How to make a long-distance relationship work in physician residency
Stay positive
Here’s the good news: It generally works out for applicants in the Couples Match.
According to data produced by the National Resident Matching Program (NRMP), “in the 2024 Match, there were 1,218 couples, of which 90% (1,097) both matched. There were 87 couples where only one individual matched, bringing the total couples match rate to 93.6% and there were 34 couples where neither individual matched.”
The overall Match rate for couples closely mirrored the overall Match rate for applicants from osteopathic (92.3) 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. 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.
