Any two applicants can participate in a Match as a couple.

Participating in an NRMP Match as a couple allows two applicants to link their rank order lists, usually for purposes of obtaining positions in the same geographic location. When applicants participate in a Match as a couple, their rank order lists form pairs of program choices that are considered by the matching algorithm. A couple will match to the most preferred pair of programs on their rank order lists where each partner has been offered a position.

Setting Couple Status in the R3 System

Applicants must register individually for a Match in the Registration, Ranking, and Results (R3) system before one partner can send a couple request through the R3 system to the other partner. Applicants must be participating in the same Match in order to couple.  Once an applicant sends a couple request to the partner, the couple fee is due regardless of whether or not the request to couple is accepted. Once the partner accepts the couple request, the partner must pay the couple fee. The process is completed when the Couple Status field in the R3 system reads “Accepted” and Fee Status is “Paid”. Couple fees are non-refundable, even if applicants later decide to uncouple.

Couples in an NRMP Match

Creating Rank Order Lists as a Couple

When creating rank order lists, couples should keep the following in mind:

  • Partners must have the same number of ranks on their respective rank order lists.
  • Each partner can submit no more than 300 ranks on their respective rank order lists.
  • Couples have the option to rank a “No Match” code. When the No Match code is entered by one partner, it means that if the other partner can be matched at that rank, the partner ranking the No Match code will not match. The No Match code for residency programs is 999999999 and for fellowship programs is 888888888. Pairs of ranks using the No Match code should be placed at the bottom of the rank order list so that both partners have the best chance of matching to programs.
  • Specific to the Main Residency Match:
    • If either partner ranks an advanced program on a primary rank order list, a supplemental rank order list of preliminary programs can be attached to the advanced program to obtain a full course of training; however, supplemental rank order lists are considered individually by the matching algorithm, not as a unit, and only after a match is established to a pair of programs on the partners’ primary rank order lists.
    • Applicants who list the same advanced program more than once on the primary rank order list, must have the same supplemental list or no supplemental list attached to each instance of the advanced program.
    • Each partner of a couple may rank up to 20 unique program codes on their primary rank order lists and up to 20 unique program codes on all their supplemental rank order lists combined before an extra rank fee of $30 per additional program code is charged. The “No Match” program code is considered one unique program. Additional fees will be charged for rank order lists with 100 or more ranks. 

Ranking Resources

Couples and the Matching Algorithm

When the matching algorithm encounters a couple:

  • A match is established only if both partners match at a pair of ranked programs.
  • Partners are treated by the matching algorithm solely as a couple. If applicants do not obtain a match as a couple, the algorithm does not process their rank order lists separately to find a possible match for each individual.

Couples and the NRMP Matching Algorithm

Deciding to Uncouple

Prior to the applicable Rank Order List Certification Deadline, if individuals who have coupled in a Match subsequently choose to participate in that Match as individuals, or if one partner wants to withdraw from the Match, both partners first must uncouple in the R3 system. Once uncoupled, each individual must adjust their rank order list by removing any duplicate programs and re-certifying their lists before the Rank Order List Certification Deadline.