Software Helps Medical Couples Stay Together

By Jennifer Ghandhi

Josh and Ginger Menendez (with their son) carry out a Match Day tradition—filling in their names and residency location on maps of the U.S. and Alabama.

Compromise is an important part of any relationship, but for couples preparing to graduate from medical school, the balance between give and take involves a third party: a computer program.

Each year, senior medical students must compete with thousands of fellow students and recent graduates for residency training positions at hospitals across the country. The doctors-to-be rank their destinations of choice; residency programs do the same for their preferred applicants. The final decision comes from the National Residency Matching Program (NRMP), a private, nonprofit organization that uses a complex, computerized algorithm to decide the best way to pair everyone up. Results are announced at medical schools across the country on Match Day—a nationwide event featuring sealed envelopes and a high dose of tension.

Family Medicine

For engaged or married seniors in medical school, an already tricky process becomes significantly more complex. “There is a way for the computer system to link two students who want to stay together,” explains Laura Kezar, M.D., associate dean of students at the UAB School of Medicine. Known as the Couples Match, this process allows any two people to try to match at residency programs in the same location. (Although the two are usually an actual couple, students who hope to open a practice together also have been known to choose the Couples Match.)

This year put an additional strain on the NRMP’s electronic brain: Nationally, a record 808 couples chose to enter the Couples Match, including six from UAB. On March 18, those students joined the other 150 members of the School of Medicine’s 2010 graduating class in Volker Hall to find out where they would begin their next phase of medical training.

Multiple Choice

Married couple Josh and Ginger Menendez both successfully found residency slots at UAB, but they still had to put in a lot of miles in the months leading up to Match Day. “Generally, couples must interview at and rank more programs to assure a match,” Ginger says. That’s especially true when, like the Menendezes, each person is pursuing a different specialty: Ginger in pediatrics and Josh in neurosurgery. The couple also faced an added challenge, because their first child was born during interview season.

Residency programs start accepting applications in July, and they must be submitted by September. Programs extend interview offers to promising candidates in the fall, the interviews and hospital tours take place through the winter, and students must submit their ranked lists in February.

Like medical school, the match process is a marathon rather than a sprint, says Justin Routman. Routman (specializing in anesthesiology) and his fiancée, Jamie Bishop (obstetrics and gynecology), each applied to 38 programs and interviewed at 13. The couple met on the first day of medical-school orientation, and they got engaged two years later. They have been apart for much of the time since then, with Routman completing his clinical training at the School of Medicine campus in Birmingham while Bishop finished her training at the school’s Huntsville branch. That separation was enough to convince them they wanted to be together during residency. “We applied to more programs because we knew this was a particularly tight year, and it was going to be even more difficult to find a place that liked both of us and that we both liked,” Bishop says.

The Price of Togetherness

The all-important pre-Match rankings force couples to weigh a host of factors, including the relative prestige of programs in different specialties and the personalities of their future trainers. “It’s more nerve-wracking to match as a couple,” Routman says.

Justin Routman and Jamie Bishop

“It’s hard enough to evaluate yourself, how your interview went, how well you would fit in at a program, and how much you would like a city, but when you introduce another applicant into the mix, it’s another story. No one wants to feel as though they are hindering—or, for that matter, being hindered by—their partner. We all hope we are strong applicants, but even if two individuals have similar class ranks, one may be an outstanding applicant in his or her field of choice, while the other is only a mediocre applicant.”

The match process was the couple’s first real exercise in compromise, adds Bishop. “There were programs that one of us liked a lot and would have ranked as our first choice, but you can’t do that if the other would be unhappy there,” she says. “The most difficult part was coming up with a final rank list that we felt would satisfy both of our needs.”

If all else fails, going it alone is always an option. Kezar explains that students can rank their lists so that their choices are run separately if they don’t make a dual match. “Some people think it’s more important to choose the best program regardless of whether you get to be with your significant other, and we respect that belief,” Bishop says. “However, we were not willing to be separated if we could help it.” Bishop and Routman got their wish: They both successfully matched at the University of Michigan, Ann Arbor.

Prescription for Success

Hugh Davidson Reeves (internal medicine) and Michelle McCurry Reeves (psychiatry) were also determined to match together. The two began dating just before medical school and married after their third year of school. “We planned to do the Couples Match all along,” Michelle says. They chose to concentrate on programs in the Southeast, applying to 18 programs and interviewing at a dozen of those; they even timed their visits to travel together when possible. Many programs were very accommodating, they say, but they ended up being able to stay at home—both matched at UAB.

Michelle and Hugh Reeves

The UAB School of Medicine offers a variety of resources to help prepare students for the Match, notes Kezar, including seminars covering common interview questions and detailed timelines of key dates. That training paid off, says Bishop. “It definitely seemed like UAB students were more confident and well-prepared than most other students I encountered on the interview trail,” she says. UAB’s reputation is another advantage, adds Josh Menendez. “The school has a history of producing graduates who are clinically excellent, and that helps current applicants in the Match.”

Despite the fact that the 2010 Match Day was one of the most competitive in recent memory, UAB medical students did extremely well, says Kezar. “Ninety-eight percent of our graduates matched to a program of their choice on the first round of the Match, higher than the national average of 93 percent, and all had been successfully matched by the end of the proceedings.” (See “Match Day: By the Numbers.”) The members of the class of 2010 will start their residencies this summer at 69 hospitals in 29 states.