Couples Match Letter of Intent: What to Send

Couples Match Letter of Intent: What to Send

In the couples match you rank pairs, so an honest letter of intent commits to a pair, not a program. Each partner writes only to their own program, names the partner, the partner's specialty and the partner's program, and makes a ranking statement only if that pair sits at the top of both lists. NRMP: "A match is established only if both partners match at a pair of ranked programs."

Most letter-of-intent advice assumes one applicant and one list. A couple has two lists that move together, two specialties that may have opposite rules about letters, and two departments that may never compare notes. The common mistake is the one-applicant sentence, "I will rank you first", written by someone who cannot promise it alone. This page shows the three commitment sentences a couple can truthfully write, and two constructed letters built on them. For the general rules, start with the 2027 residency letter of intent guide.

Every NRMP and specialty document quoted below was checked on November 7, 2026, for the 2027 Main Residency Match.

How the couples match changes the commitment sentence

NRMP's Couples in the Match page sets the mechanics:

• "their rank order lists form pairs of program choices that are considered by the matching algorithm."
• "Partners must have the same number of ranks on their respective rank order lists."
• "Each partner can submit no more than 300 ranks on their respective rank order lists."
• "If applicants do not obtain a match as a couple, the algorithm does not process their rank order lists separately to find a possible match for each individual."

So your first rank is a pair. If your partner's program in that pair is in another city, "I will rank you first" is true for your rank line 1 only if the pair on line 1 contains this program. A couple can put your program on line 1 and line 2, paired with two different programs for your partner. A program can read "first" in a couple's letter more than one way, so say which pair you mean.

The 2027 Match Participation Agreement makes accuracy a duty. Section 6.3 covers "All written, electronic, and verbal information provided to programs and program representatives throughout recruitment" and says: "Applicants who submit incomplete, misleading, false, or plagiarized information may be deemed to have violated this Agreement." (2027 MPA)

Where the 2026–27 rules mention couples

Specialty guidance names couples mostly before interviews, as a reason contact can be acceptable:

None of these creates a post-interview exception for couples. The pre-interview letter of interest for a couple is a different document, covered in residency letter of interest before the interview.

Specialties that still say don't send

After the interview, couples follow the same specialty rules as everyone else:

• Dermatology: "Post-interview communication of preference – including “letters of intent” and thank you letters – should not be sent to programs."
• Plastic surgery (integrated): "There will be NO communication between faculty and applicants after the interview except for faculty communicating with their own advisees." (ACEPS, updated February 2026)
• Family medicine: "Applicants are discouraged from sending letters of interest or intent to rank." (OPDA family medicine)
• Psychiatry: "No post-communication aside from a simple thank-you is recommended."
• Pediatrics: "Letters of intent are not expected and, if sent, should only be sent to one program." (APPD)

Partners often sit on opposite sides of this list. If you are in dermatology and your partner is in internal medicine, your partner may write to their program and you send nothing to yours. Your partner's letter can name you and your specialty. It should not speak for you to your department.

Who writes, to whom, and the subject line

The University of Maryland School of Medicine's residency application manual says a letter of intent "should be brief and direct" and "should be addressed to the Program Director and cc'd to the Program Administrator". For a couple, add:

• Each partner writes only to programs they interviewed with. You write to your program; your partner writes to theirs.
• Name the couple in the subject line, so a coordinator can link the files: "[Your name], [specialty] applicant, couples match with [partner's specialty]".
• Give your partner's name, specialty, program and AAMC ID in the first paragraph.
• Send on the same day as your partner, with commitment sentences that describe the same pair.
• Send before your program could lock. Internal medicine, pediatrics and vascular surgery programs in NRMP's voluntary lock pilot lock by 11:59 p.m. EST on Monday, February 8, 2027, per NRMP's 2027 lock timeline. Every list is certified by 9 p.m. ET on Wednesday, March 3, 2027.

Unknown: none of the NRMP or specialty documents quoted here says whether two departments at one institution compare couples' letters. Write each letter so it would be accurate if both departments read both.

The commitment sentence: three honest versions

Version A, same-institution pair first. "[Partner] and I will rank the pair of [Institution] [your specialty] and [Institution] [partner's specialty] first on our couples list." True only if that pair is line 1.

Version B, city first, institution open. "[City] is our first choice, and the pairs that include your program are at the top of our list." Use it when your top lines pair your program with two or more of your partner's options.

Version C, no ranking claim. "We are couples matching and hope to train in [city]; your program is one we will rank highly." Use it when the list is not settled or your pair depends on your partner's interviews.

What fails: telling two departments in different cities that each is "our first choice". Only one pair can be line 1. That is the kind of "misleading" information MPA §6.3 names.

Our view: pick the weakest version that is true, and say it once. The basis is MPA §6.3 and the couples algorithm: your rank line 1 belongs to a pair, so any sentence about "first" has to describe that pair. The countercase: a couple with one acceptable city and one hospital that has both specialties can use Version A with no risk, and should; a vague letter there throws away the one fact a program cannot see on its own.

Two constructed couples letters, annotated

Both letters are constructed examples, written by us, not real applicant letters. Names and programs are invented.

Constructed example 1: same-institution pair (internal medicine and emergency medicine)

Constructed example, written by us, not a real applicant letter. Context (invented): Ines Carvalho applies in internal medicine and her partner, Tobias Ferreira, in emergency medicine. Both interviewed at "Lakeshore University". Their list puts the Lakeshore pair on line 1. Internal medicine's 2026–27 guide asks programs to tell interviewees not to send thank-you notes, but it does not bar letters of intent. Emergency medicine's guide says "There is no requirement nor suggestion that post-interview communication be sent".

Subject: Ines Carvalho, internal medicine applicant, couples match with emergency medicine

Dear Dr. Lindgren,

I interviewed with Lakeshore University Internal Medicine on December 9. I am couples matching with my partner, Tobias Ferreira (AAMC ID 00000000), who interviewed with Lakeshore Emergency Medicine.

Tobias and I will rank the Lakeshore pair, your internal medicine program and Lakeshore emergency medicine, first on our couples list. Your ambulatory block, where interns keep the same clinic panel all year, is the training I described to you at lunch, and I want to build it at Lakeshore.

Thank you for the time your faculty and residents spent with me.

Sincerely, Ines Carvalho, AAMC ID 00000000 cc: Program Coordinator

Why each part is there:

• The partner's name, specialty and AAMC ID come before the commitment, so the program can link the files.
• "the Lakeshore pair … first on our couples list" is Version A. It names the pair, so "first" means exactly one thing.
• One program-specific reason, with where she learned it, rather than a restated application.
• No question about ranking. NRMP's Code says applicants "must not request a program director or any member of the recruitment team to disclose program ranking preferences or intentions."

Constructed example 2: same city, different institutions (general surgery and anesthesiology)

Constructed example, written by us, not a real applicant letter. Context (invented): Marcus Webb applies in general surgery; his partner, Lena Fischer, in anesthesiology. Their top city is "Riverton". Their list will put Marcus's program at "Riverton General" on lines 1 and 2, paired with Lena's two Riverton anesthesiology programs, and Lena has not decided which of her two goes first. General surgery's guide says post-interview communication "is acceptable but not required"; anesthesiology's says applicants who want to send a letter of interest "are welcome to do so".

Subject: Marcus Webb, general surgery applicant, couples match with anesthesiology

Dear Dr. Chen,

I interviewed with Riverton General Surgery on January 13. My partner, Lena Fischer (AAMC ID 00000000), is applying in anesthesiology and interviewed at two Riverton programs.

Riverton is our first choice, and the pairs that include your program are at the top of our list. Your night-float structure, which the chief residents walked me through, is the schedule I want for my intern year.

Thank you again for a well-run interview day.

Best regards, Marcus Webb, AAMC ID 00000000 cc: Program Coordinator

Why it works:

• Version B, because Version A is not yet true. The couple cannot name their line-1 pair until Lena orders her two programs. "Your program is my first choice" would hide that his partner's half is still open.
• It names the city as the couple's choice, the fact a program cannot see.
• It is short. Two paragraphs after the greeting, with one specific reason.

If one partner's plans change

• Before 9 p.m. ET on March 3, 2027: NRMP says couples who decide to match as individuals "first must uncouple in the R3 system", and each partner must remove duplicate programs "and re-certifying their lists before the Rank Order List Certification Deadline."
• After the deadline: if one partner is withdrawn or found ineligible and the couple has not uncoupled, MPA §3.3.1 says NRMP will "Uncouple the individuals, remove duplicate programs and “no match” ranks from the rank order list of the eligible individual, and process the rank order list of the eligible individual."
• If a letter you sent no longer holds: §6.3 makes you responsible for "the completeness, timeliness, and accuracy of all information provided to programs." Send one plain line to that program saying you are no longer couples matching. Our guide to a changed first choice covers the correction email.

For building the pair list itself, including where No Match pairs go, see couples match rank list strategy.

Questions about couples match letters

Should both partners send a letter of intent?

Only if both specialties allow one and both sentences describe the same pair. If one specialty asks applicants not to send, that partner sends nothing.

Can I tell a program I will rank it first if my partner might not match there?

Only as "the pair of [your program] and [partner's program] first". Your program is line 1 only together with your partner's line-1 program.

Should I write to my partner's program?

No. Write to programs you interviewed with. Your partner writes their own letter.

Do I need to tell a program I am couples matching?

The MPA and Code text quoted on this page does not name couples status as something you must disclose, and MPA §6.4 gives you the right to keep ranking preferences confidential. If you send a letter with a ranking statement, include the couple, or the statement is misleading. If one partner can't honor a match, the NRMP waiver rules apply to that partner's position.

In anesthesiology, OPDA tells couples to signal the same programs.

Dental residency applicants follow different rules: the Dental Match letter of intent rules prohibit saying 'I will rank you first'.

Get a free review of your letter of intent

Get a free Quick Review of your letter of intent against GradPilot's residency letter of intent rubric. It reads whether your interest is stated at a strength the rest of the letter supports, whether your reason for the program comes from what you learned there, and whether any sentence asks the program about its ranking.

More residency letter guides:

• Residency letter of intent examples: three annotated single-applicant letters.
• Residency update letter after the interview: the update NRMP requires and the ones it does not.
• Medical school and residency essay guides: all residency and medical school writing guides.

Sources

Retrieved November 7, 2026.

• NRMP, Couples in the Match: pairs, rank limits, algorithm, uncoupling.
• NRMP, 2027 Match Participation Agreement for Applicants: §3.3.1, §6.3, §6.4.
• NRMP, Match Code of Conduct for Applicants.
• NRMP, 2027 Voluntary ROL Lock process and timeline; 2027 Main Residency Match calendar.
• APD, Statement on the 2026–2027 application cycle (May 1, 2026).
• OPDA 2026–2027 guides: psychiatry, anesthesiology, family medicine, internal medicine, emergency medicine, general surgery.
• APPD, 2026–27 Pediatrics Residency Recruitment Recommendations.
• ACEPS, Post-interview communication policy (updated February 2026).
• University of Maryland School of Medicine, Residency Application Manual: The Interview.