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, 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 Shapleyís (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 manipulated by couples acting as singles.