I consider myself one of the lucky ones because my wife and I couples matched to the same institution for residency. At the time we put our residency match lists in, we were just boyfriend and girlfriend, and the decision to couples match felt like a bigger leap forward for our relationship than deciding to ask her to marry me about a year later. It was the right decision for us, but it isn’t necessarily the best path for most people.

The “normal” match has its own emotional struggle. However, the catch with the couples match is that both the fate of your career and relationship are riding on the outcome of the match algorithm.

If you have already made a lifelong commitment to your significant other (i.e., marriage or children), then another long-term commitment probably won’t cause too much extra strain. That is especially true if that lifelong commitment was made with implicit/explicit agreements to sacrifice time, energy, and career ambitions for that person.

For more transient commitments like a boyfriend/girlfriend the choice is less clear, but there are at least two major benefits: 1) It can keep you and your partner geographically close; and, 2) it is an opportunity for the stronger candidate to improve the candidacy of the weaker one.

Having spent the last two years at the same institution as my wife has been invaluable. We are in different residencies (internal medicine for her, radiology for me), but being at the same institution allows us to help each other navigate our institution’s quirks. Even if we didn’t match at the same institution, living together close to the hospital has made it relatively easy to surprise each other with dinner or some much-needed caffeine while on a long call shift.

Having my application attached to my Californian wife also helped our California residency programs look past the fact that I’m from out of state. My wife was also by far a stronger academic candidate (AOA, Gold Humanism Society, and board scores I am still jealous of). It’s not inconceivable that her program reached out to mine to let them know they really wanted her, which may have helped me bump up on their list.

My wife and I were not the only couples to go down this road from our medical school, and several of these couples were also in the boyfriend/girlfriend stage of their relationship. Generally, everyone matched roughly where they wanted to be and appear to still be in healthy relationships. However, there is one major drawback: the possibility for resentment.

Lots of unexpected twists can and do happen on the interview trail and during residency. Red flags surface, priorities change, and couples break up. If you ended up in a place you didn’t want to be because of your partner and then your relationship ends, it’s hard not to harbor some resentment towards your now ex-partner.

An attending while in medical school told me that you should only couples match if you think you couldn’t live without that person. In his position as a residency program director, I got the impression he saw many people get themselves into tough positions after they made commitments they weren’t ready for. He urged me to think about how I would react if being together meant ending up at the bottom of our match lists.

It didn’t feel great thinking about it at the time. However, it was a wakeup call that the person who would become my wife was someone I was willing to sacrifice to be with and pushed me to initiate some heartfelt discussions. Although at times we disagreed about the execution, our priorities were aligned, and our relationship is far better after these discussions.

If you decide not to couples match, it doesn’t mean your relationship is over. There are several programs in almost every major city, and I also know of couples who matched independently to the same institution. Instead, it just indicates that at the moment your list goes in, you are not ready to make a commitment close to the level of marriage. To couples match, you should honestly be able to say that regardless of program, you and your partner are stronger together. If you can say yes, then the Match does seem to favor couples, and working together, you can end up at your dream program with your dream person.

Lucas R. Cusumano is a radiology resident.

Image credit: Shutterstock.com