Couples Match Fosters Togetherness
The luckiest day of his life, says University of Wisconsin School of Medicine and Public Health (SMPH) Dean Robert Golden, MD, was his first day of a physics laboratory when he was an undergraduate student at Yale University in New Haven, Connecticut. He was late for class, as was another student, Shannon Kenney, now also an MD. Through their tardiness, they became lab partners, then life partners.
Eventually, the two went on to separate medical schools, Kenney to Yale and Golden to Boston University, but later were able to match together into residencies at the University of North Carolina at Chapel Hill (UNC). They moved to Chapel Hill shortly after their May 1979 wedding.
In 2006, they moved their dual academic medicine careers to the School of Medicine and Public Health, where Kenney is the Wattawa Bascom Professor in Cancer Research and a professor of oncology and medicine.
Kenney directs a highly productive research team in the McArdle Laboratory, which studies the role of Epstein-Barr virus in the pathogenesis of cancer. She also serves as an attending physician on the Infectious Diseases Consult Service at UW Hospital and Clinics.
While matching couples together into residencies was uncommon 34 years ago, it has become more common as the number of women entering medicine has increased.
“Shannon was one of less than a dozen women in a class of 100 students,” Golden notes. “Now, most medical schools have equal numbers of men and women among their medical students. The world of academic medicine was not accustomed to couples matching when we were in school. There were fairly strong pockets of chauvinism and sexism in medicine then.”
In 2013, a record 1,870 students in U.S. medical schools - 935 couples - applied for joint residencies. Those who tried to match together had a 95.2 percent success rate.
How the Match Works
Before Match Day - held simultaneously around the U.S., generally during the third week of March - couples who want to match together and individual students provide a list of their preferred residency locations. Those choices are fed into a specialized computer program that makes the assignments for all students in the U.S.
“The two partners identify themselves as a couple to the National Residents Matching Program (NRMP) and submit their lists,” explains Christopher Stillwell, director of student services at the School of Medicine and Public Health. “The algorithm treats their lists as a unit, matching the couple to the highest-ranked program choices for which both partners match.”
“Couples approach the constraints of the couples match differently, and they may have to make trade-offs when they develop their paired lists,” adds Stillwell. “Most of them want to end up at the same hospital, but many simply want to end up in the same city. Some couples are willing to accept greater geographic distance if it means they both can go to higher-ranked programs in their fields.”
Stillwell notes, “The school doesn’t have any control over how the couples’ matching is done and who will be successful. Any students can register for the couples match if both wish to do so. They apply and interview just like other applicants.”
Couples have no guarantee that they will match into their top choice. However, they will have more success if both are willing to serve in residencies in high-demand fields, such as primary care, explains Stillwell.
“The NRMP does not provide schools with information regarding how applicants or the school’s aggregate fared in the match,” Stillwell adds.
Compromise Pays Off
Golden says he and his wife had to make compromises regarding their residency location to match together in 1979. He wanted to attend a program with an outstanding reputation in psychobiological research, and Kenney was interested in another institution known for its highly ranked pediatrics program.
“We made a mutual compromise - Shannon’s first-choice institution didn’t have a strong psychiatric research program,” he shares. “Both of us viewed the University of North Carolina at Chapel Hill as our second choice, so we decided to put that at the top of our match list, and that’s how we successfully matched there together.”
Going to North Carolina worked out the best for them, adds Golden.
“Shannon matched in the combined medicine–pediatrics program at UNC and discovered that she really loved internal medicine, even more than pediatrics,” he says. “By making this compromise, she ended up having an opportunity she otherwise wouldn’t have had at her favorite pediatrics program.”
His experience was similar.
“I was one of only two residents in my cohort with an interest in research,” Golden notes. “As a consequence, I received an incredible amount of encouragement and mentoring from nationally renowned senior leaders in the field. They spent a lot of time helping me develop my interests.”
Match Day mechanics were probably the same in 1979 as they are today, he notes, but couples rarely asked to match together.
“At most places where we interviewed, they weren’t used to matching couples, and departments did not have much experience working together to accommodate such requests,” Golden explains.
The way students learn where they will attend residency also has evolved.
“They had a designated time to put all the match envelopes in students’ mailboxes, but they didn’t have enough people to fill all the mailboxes at once,” says Golden, of his experience at Boston University. “At eleven o’clock, when the residency assignments were made available, you had to wait until you saw a letter enter your mailbox. I remember watching my colleagues randomly receive their envelopes, compared to the thoughtful and coordinated way we now conduct Match Day - where the entire class, including many spouses and children, shares the experience in a very special ceremony.”
Follow the Heart and Follow the Advice
The 2013 Match Day ceremony was a nervous time for Drew Livermore and Jackie Israel, of Sheboygan and Eau Claire, Wisconsin, respectively. After a lengthy friendship, the two began dating in their third year at the School of Medicine and Public Health; they decided to match as a couple before the start of their fourth year. A potential drawback was that both wanted to enter highly competitive specialties: orthopedic surgery for him and plastic surgery for her.
“That was the most challenging part,” Israel says. “The best advice I got was ‘if you want to be with this person, it’s worth it.’”
Livermore notes, “Chris (Stillwell) had some scary numbers concerning our chances of matching to the same institution in competitive specialties. But he also gave us some encouraging advice. He said ‘if you mean that much to each other, you can figure out a way to make it work.’”
Israel recalls, “It was not a decision we took lightly. We are so thankful for the advice we received from our mentors and family throughout the process.”
Livermore and Israel put UW Hospital and Clinics at the top of their list.
“We just loved this place the most,” Livermore exclaims. “We thought it would be a great place to train. The people here make the UW unique.”
On Match Day, the two awaited their turn to find out their residencies.
“I was definitely nervous about opening that envelope, wondering if Drew’s said something different from mine,” Israel states.
“It was very scary to go up and open an envelope that contained information about both of our futures,” Livermore reflects. “It’s strange to feel like you have little control as far as where you will go for residency, and to find out in front of fellow classmates.”
Luckily, their fears subsided when they learned that both would enter residencies at UW Hospital and Clinics. Livermore’s residency will last five years, while Israel’s will be six or seven.
“We’ll never experience anything like our Match Day again,” Livermore says. “It was an incredibly happy day. We could have ended up in different cities much lower on our match list.”
Both are convinced that working in the same hospital will help them in their quest for successful medical careers.
“Jackie is my biggest support in and outside of the hospital,” Livermore shares. “I am incredibly lucky to have her with me as we take on the challenges of residency.”
Israel adds, “Drew is my best friend. As our relationship has grown from friendship to romance, it’s only gotten stronger.”
Helping Plan for the Future
Another School of Medicine and Public Health alumni couple share similar sentiments.
Nathan Gundacker and Connie Uttech met in a sixth-grade science fair, where they posed for a picture for their hometown Beaver Dam, Wisconsin, newspaper. They started dating as high school seniors and got married after earning their undergraduate degrees from the UW-Madison.
In 2011, during their final semester at the School of Medicine and Public Health, they matched as a couple to residencies at the University of California, Davis, in Sacramento. Connie’s specialty is pediatrics; Nathan’s is internal medicine.
Two years later, the Gundackers say things are going well, and they are grateful for the opportunity to match as a couple.
“It made the match process much easier to be able to match as a couple and know we were going to the same place versus trying to match individually and hope to end up together,” Connie explains.
Nathan notes, “Living separately was not something we wanted to do, and we did not rank any programs separately. Thankfully, together, we got into programs that we wanted.”
Connie says being in the same hospital has been a convenience in their marriage even when they work different shifts.
“During intern year, I worked the Christmas Day shift, and Nate worked the Christmas night shift,” she shares. “By working in the same hospital, we were able to grab a quick Christmas dinner together in the hospital cafeteria while I was leaving and Nate was arriving. That would not have been possible if we worked at different hospitals.”
They say their residencies also have helped them make future career decisions.
“My residency has helped me figure out what I want to specialize in,” says Nate, who plans to apply for infectious disease fellowships this year.
“Residency has been challenging, yet rewarding. It’s fun to work in the field that I really enjoy. After residency, I am planning to work as a pediatric hospitalist while obtaining a master’s degree in public health and a diploma in tropical medicine. We both have long-term goals to work in global health,” says Connie.
Comparing the uncommon nature of couples matches in 1979 to today, Golden says it is encouraging to see this opportunity become more possible in an effort to support families and relationships.
“What I learned through the match experience remains true - that family is what matters the most. While professional work is important, you have to keep things in perspective,” Golden shares.
“It’s really helpful to go through the challenges of residency with a partner who understands it, as was the case for us and many of our colleagues,” he adds. “I can’t imagine how stressful it would be to go through residency with a spouse who lives far away because they didn’t match together or because the spouse is in the military, for instance. For whatever reason, that separation would limit one of the most significant sources of support.”
By Mike Klawitter
This article appears in the summer 2013 issue of Quarterly.
Date Published: 09/05/2013