Advice after somewhat disappointing couples match

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ForHumors

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Hey all, I'm hoping to get some perspective on something I've been struggling with since match day. I couples matched with my significant other, who applied to a more competitive specialty than me. I was a highly competitive applicant from a top 10 school (AOA, Steps >260, multiple pubs and awards) and my significant other was well above average, but grades/scores/department support weren't on the same level as what I had. Going into the process I knew I would have to make compromises.

And I certainly did: declining interview invites from top 10 programs that my significant other was rejected from, ranking other top 10 programs I loved at the bottom of our list because she ultimately didn't get an interview there or in that area. We did have a few wins, including when she got an interview near one of the big, really shiny, tip-top programs I was most excited about. I got really clear, good signals from the PD of that program post-interview. We ended up ranking that combination #1.

Fast forward to match day. Ended up dropping a few spots on our list, with me at a really solid, well-regarded academic program in a preferred location and her at a place nearby that she really likes and is excited about. I feel I don't have the right to be disappointed because we ended up couples matching together and I wouldn't want to change that. After all, I know so many couples have to do distance, fall way lower than they hope, or break up. But it stings to wonder if I missed out on that top choice that I wanted and hoped for. As someone who wants to stay in academic medicine, I think I'll get enough opportunities where I am, but it's not going to be options abound like at my #1. And, frankly, I did want the prestige of training there to be on my CV for the remainder of my career.

Anyway, being disappointed about this has got me in more of a rut than I expected and it's making it really difficult for me to be excited about intern year. I'd like to move on but it's easy to ruminate. Would appreciate anyone telling me about how they managed to get over something like this... or to be set straight and told to shut up. Either way, grateful for the perspective.

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From one couples match applicant to another: At the end of the day, what you go home to will almost certainly have more meaning and bring more happiness than the details of your job.

I struggled a lot to understand the significance of a "top X" program and the implications that would have on my career. I got obsessed with rankings and thinking about their relevance to my match. By the end of the match process, I had concluded that essentially the top third/quartile of programs (at least in my field, anesthesiology) all provide similar training and similar career opportunities. Maybe this is the case for you.

The last thought I'll leave you with is that not being at the #1 program almost certainly means you'll shine even brighter at the program where you'll go since you presumably won't be surrounded by as many lifelong gunners with loads of research, star-studded CVs etc. Essentially, better to be a big fish in a small pond than vice-versa.

Just my 2c. Good luck and I'm sure 5 years from now this won't be something you'll consider at all.

Edit: Also, not sure how much you're thinking about rankings from Doximity in particular, but I was really troubled by them and ended up doing a study testing the hypothesis that residency program size is an independent predictor of Doximity ranking: Association of Doximity Ranking and Residency Program Characteristics Across 16 Specialty Training Programs
 
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In my opinion, being with your SO each night far outweighs the prestige of any program. Life isn’t perfect and your SO (assuming they become your spouse) will have far more impact on your happiness than your job. The happiest people typically define themselves by the relationship they have to the people they surround themselves with-not the job they do.

You sacrificing your top choice of program shows her how much your relationship means to you. I’m not saying that means she needs to return the favor, nor should you ever expect it or hold a grudge against her. In an ideal relationship you both sacrifice for one another and you don’t keep count. You just keep giving.

An option down the line would be to do a fellowship at a highly regarded program. If you’re that interested in academics, a fellowship may well be required.
 
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Who can say whether being the rockstar resident of a slightly lesser program by reputation will open more doors than going to a top program and performing in the pack. The one thing you can influence now is being that rockstar.
 
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You will likely find opportunities and connections at your program that you would not have otherwise encountered regardless of where you went. If your program is solid (sound like it is) and you are focused and determined, your career will be more about what you make it and less of your pedigree.
 
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You're completely entitled to feel the way you feel. That said, this is literally the trade-off that one makes when you choose to couples match. And it doesn't end with the match--one of you (or both of you!) is likely going to need to compromise going forward at each step of the way to stay together.

The good news is that you are in a strong, committed relationship where you were able to talk about these difficult decisions and come up with a plan that made sense for you both. There are countless examples on these forums of people who DON'T talk things through ahead of time and wind up being very unhappy. It would be great to "have it all" and also be at your number 1 location, but ultimately despite the positive vibes you got there is no guarantee that you would have matched at your number 1 anyways. Regardless, you are at a good location, and you're with your SO. I'm sure you will do great at your current program.
 
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Thanks all. It's great to get the reassurances that once you get to a program with sufficient resources, prestige doesn't make or break an academic career. My one qualm is that it's hard to take the mentality that I need to prove myself all over again to get to where I want to go for fellowship. After all, I feel like I just worked so hard and proved myself during med school, yet it still didn't work out the way I wanted and there's no guarantee it will next time either. As @GoSpursGo says, we'll have to compromise each step of the way. But, I guess proving yourself is necessary no matter where you end up. Hopefully I can also switch to thinking with a more internal mindset too; working hard to take pride in what I'm doing, not just to get me somewhere.

When this hasn't been something on my mind, I've been really happy spending time with my SO in our new apartment. Without couples matching, I wouldn't have the opportunity to do that now or see her regularly for the next number of years. I bet that my feelings about all this will change once intern year starts. After all, I'll actually start to get to know people in my program, will be back to being busy, will have actual patients to think about, and probably will end up thinking there's no way I could've done intern year without her.
 
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Hey all, I'm hoping to get some perspective on something I've been struggling with since match day. I couples matched with my significant other, who applied to a more competitive specialty than me. I was a highly competitive applicant from a top 10 school (AOA, Steps >260, multiple pubs and awards) and my significant other was well above average, but grades/scores/department support weren't on the same level as what I had. Going into the process I knew I would have to make compromises.

And I certainly did: declining interview invites from top 10 programs that my significant other was rejected from, ranking other top 10 programs I loved at the bottom of our list because she ultimately didn't get an interview there or in that area. We did have a few wins, including when she got an interview near one of the big, really shiny, tip-top programs I was most excited about. I got really clear, good signals from the PD of that program post-interview. We ended up ranking that combination #1.

Fast forward to match day. Ended up dropping a few spots on our list, with me at a really solid, well-regarded academic program in a preferred location and her at a place nearby that she really likes and is excited about. I feel I don't have the right to be disappointed because we ended up couples matching together and I wouldn't want to change that. After all, I know so many couples have to do distance, fall way lower than they hope, or break up. But it stings to wonder if I missed out on that top choice that I wanted and hoped for. As someone who wants to stay in academic medicine, I think I'll get enough opportunities where I am, but it's not going to be options abound like at my #1. And, frankly, I did want the prestige of training there to be on my CV for the remainder of my career.

Anyway, being disappointed about this has got me in more of a rut than I expected and it's making it really difficult for me to be excited about intern year. I'd like to move on but it's easy to ruminate. Would appreciate anyone telling me about how they managed to get over something like this... or to be set straight and told to shut up. Either way, grateful for the perspective.
Talk to a therapist if you need

and also just go to work and get through it
 
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And, frankly, I did want the prestige of training there to be on my CV for the remainder of my career.

Good on you for being honest with yourself about this.

If you care about prestige within medicine: your fellowship, attending positions, and your academic output will be arguably bigger factors in how "shiny" your CV is.

If you care about prestige outside of medicine: I don't believe a single layperson has ever asked me where I did my residency; they all ask where I went to school and you still have this:

I was a highly competitive applicant from a top 10 school
 
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