In this note we study the national resident matching program (nrmp) algorithm in the us market for physicians. We report on two problems that concern the presence of couples, a feature explicitly incorporated in the new nrmp algorithm (cf. Roth and peranson in am econ rev 89:748–780, 1999). First, we show that the new nrmp algorithm may not find an existing stable matching, even when couples’ preferences are ‘responsive’, i.e., when gale and shapley’s (am math monthly 69:9–15, 1962) deferred acceptance algorithm (on which the old nrmp algorithm is based) is applicable. Second, we demonstrate that the new nrmp algorithm may also be anipulated by couples acting as singles.