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Couples Match: How Residency Interviews Work for Couples
How the NRMP couples match pairs your rank lists, how to line up interviews with your partner, and how to answer “are you couples matching?”
In the NRMP couples match, two applicants link their rank lists into pairs of programs, and the Match places them at the highest pair where both get a spot. If no pair works, neither of you matches through the algorithm. For interviews, the work is coordination: apply to the same cities, signal the same programs where you can, and schedule so both of you can attend. Telling programs you are a couple is your choice.
How the couples match works
Any two applicants can match as a couple, in the same specialty or different ones, usually to train in the same area. Coupling happens in the NRMP's R3 system, not in ERAS:
- Each of you registers for the Match on your own in the NRMP's R3 system. You both have to be in the same Match.
- One of you sends a couple request to the other in R3.
- The other accepts the request and pays the couple fee. The fee is due once a request is sent, even if it is declined, and it is not refunded if you later uncouple.
- You are coupled when R3 shows Couple Status as Accepted and Fee Status as Paid.
Rank list rules for couples
Your lists are pairs
Each rank on your list is paired with the same rank on your partner's list. The algorithm tries your first pair first, then your second, and so on.
Both lists are the same length
You must have the same number of ranks, up to 300 each. Ranking more than 20 program codes each adds a fee per extra code, and a program can appear many times, paired with different programs for your partner.
The No Match code
One of you can rank No Match (999999999) opposite a real program. If the Match reaches that pair, your partner matches and you don't. The NRMP says to put these pairs at the bottom of the list.
You match as a couple or not at all
If no pair works, the algorithm does not go back and run either of your lists alone.
Supplemental lists
If you rank an advanced program, you can attach a list of preliminary programs to it. Those lists are used one partner at a time, and only after you match to a pair.
Uncoupling
If you decide to go as individuals, or one of you withdraws, you both have to uncouple in R3 before the rank list deadline. Then each of you removes duplicate programs and certifies again.
For how the algorithm treats a single list and how to order it, see how to build your rank list. The NRMP also has short couples match videos.
Should you tell programs you're a couple?
ERAS asks, but you choose
The Match Information section of the 2027 ERAS application asks whether you are participating as a couple in the NRMP, and if so your partner's name and the specialties your partner is applying to.
The answer goes out with your application
Once you certify and submit, the AAMC says your application is locked and goes to every program you apply to this season. Decide before you submit.
Disclosure is voluntary
The NRMP's December 2025 policy note says applicants are not required to disclose a couple, and programs should not require it.
Why many couples tell
If you have shared it, programs at the same institution may talk to each other about you and your partner, which can help with interview logistics and invitations.
How programs rank couples
The same note asks programs to rank on the strength of your application and fit, not to guess what a couple will do, and the NRMP tells everyone to rank by true preference.
Lining up interviews together
- Build one shared map of cities: List the cities and institutions where both of you could train, with each partner's programs side by side. Apply wide enough in those cities that each of you has programs within reach.
- Signal the same places: Anesthesiology's program director guide asks couples to signal the same programs whenever possible. Check your own specialty's signal rules on the season page.
- Accept fast and keep a shared calendar: Programs must give you at least 48 hours to answer an invitation. Put every invitation, date and response deadline in one calendar you both see.
- When only one of you is invited: Psychiatry's and dermatology's guides name a couples match as a reason you may contact a program before interviews. Anesthesiology's guide says asking for an interview you did not signal because your partner was invited is discouraged and unlikely to work.
- Release what you won't use: Accept only interviews you plan to attend, and give programs reasonable notice when you cancel, one to two weeks in the NRMP's example.
- Write notes the same day: Each of you writes three lines after every interview. In February you rank pairs, and those notes are what you compare.
Offer dates differ by specialty, so one of you may hear weeks before the other. The residency interview season guide has each specialty's release dates and signal counts.
When an interviewer asks “Are you couples matching?”
Here is what each couple question tests and an outline for your answer.
Are you couples matching?
What it tests: Whether your plans could make you hard to rank, and whether you can talk about it without strain.
Outline: A one-line yes or no, your partner's specialty if you choose to share it, the region you are both aiming for, then back to why this program.
Has your partner interviewed here?
What it tests: Logistics, and how seriously you are both considering the city.
Outline: Say where their process stands in a sentence. You don't have to name other programs: the Match Participation Agreement lets you keep the programs you applied to confidential.
Why this city?
What it tests: Whether you would come and stay for reasons beyond your partner.
Outline: One reason tied to your partner, then two tied to you: the patients, the training and the life you want there.
What will you do if you don't match together?
What it tests: Maturity and honesty about a hard scenario.
Outline: Say you have planned for it as a couple, without giving away your rank list, and show you would commit fully to whichever program you match.
How couples do in the Match
The NRMP publishes each year's results, couples included, in Results and Data: 2026 Main Residency Match. If you want to send a letter after interviews, check what each of your specialties allows in our letter of intent guide.
Sources: NRMP, Couples in the Match, Policy Corner, December 2025: Couples in the Match, couples rank limit help item and the 2027 Match Participation Agreement. AAMC, 2027 ERAS Applicant Worksheet and 2027 MyERAS Applicant User Guide. Program director guides 2026-27: anesthesiology, psychiatry and dermatology. NRMP reports are linked, not quoted. All checked October 18, 2026. ERAS, NRMP, and CaRMS are trademarks of their respective owners. Confetto is not affiliated with them.
Frequently asked questions
How does the couples match work?
Both partners register for the NRMP Match, couple in the R3 system and certify rank lists of the same length. Each rank is a pair of programs, one for each partner. The Match places you at the highest pair where both of you get a spot.
Do couples have to be in the same specialty?
No. Any two applicants can match as a couple, as long as both are in the same Match. Each of you ranks programs in your own specialty, and the lists are paired.
Do I have to tell programs I'm couples matching?
No. ERAS asks whether you are participating as a couple, but the NRMP says disclosure is voluntary and programs should not require it. If you share it, programs at the same institution may coordinate your interviews.
What happens if one partner doesn't match?
A couple matches only as a pair. If no pair on your lists works, the algorithm does not run either list on its own. Pairs with the No Match code let one partner match while the other does not.
How many programs can couples rank?
Each partner can have up to 300 ranks, and both lists must be the same length. Ranking more than 20 program codes each adds a fee per extra code.
Can we uncouple after registering?
Yes, before the rank list deadline, March 3 at 9 p.m. ET Eastern for the 2027 Match. Both of you uncouple in R3, then each of you removes duplicate programs and certifies again. The couple fee is not refunded.