Multiples in medical school

Clockwise from top left: Julia and Sofia Steger; Katey and Libby Bell; Nicole and Hannah Rud; Christian and Palmer Casteel; Samantha and Allison Epstein; Aavaisra and Kashmaila Ali

A built-in study partner. Someone who understands away rotations and clinicals and the difference between MS2 and MS3. A best friend with whom to share the anxiety of Step 1 and the euphoria of Match Day.

Six sets of twins - actually, four pairs are two in a set of triplets - graduating from medical school in 2026 shared what it was like to attend medical school at the same time. In all but one case, these students also attended the same medical school, at times confounding their friends and attendings, but always setting the bar higher for each other.

Katey and Libby Bell
Indiana University School of Medicine
Katey: Dermatology
Libby: Internal Medicine

Katey and Libby Bell always knew they were destined for a career in health care. Two of a set of triplets, they were fascinated by their mother's stories of giving birth at 37 weeks at Norton Hospital, about an hour outside their hometown of Jasper, Indiana.

"We realized that if we had been born in the [early] 1900s, we wouldn't even exist," says Katey. "And I think that sparked a natural interest in learning more about what made us possible."

Katey and Libby, who are identical - and their fraternal sister, Avery - had originally planned to go to physician assistant school together and, in fact, were accepted into the pre-PA program at the University of Evansville.

But influential role models, exceptional academic records, and several key internships, including one as patient-care technicians at Deaconess Gateway Hospital in Newburgh, Indiana, convinced Katey and Libby that they had what it takes to apply to medical school. (Avery decided to continue on to PA school and is now working as a neurology PA in Dallas.)

Katey and Libby matriculated at Indiana University School of Medicine in 2022 and earned their medical degrees on May 14, with Katey headed for a dermatology residency at the University of Missouri, in Columbia, and Libby staying at Indiana University, in Indianapolis, and pursuing internal medicine, with plans to complete a fellowship in gastroenterology.

In fact, it is the first time the pair will be in separate cities, having attended high school, college, and medical school together. "We've been each other's best study buddies, best motivators," says Katey, "but I think we did a wonderful job of not only identifying ourselves separately and being our own people and having our own personalities, but also working well together and encouraging each other."

"We definitely were able to push each other to achieve bigger and better things," adds Libby, including creating an organization called Food as Medicine, which worked with local nutritionists and functional medicine physicians to teach nutritional practices to patients.

Likewise, Katey enlisted Libby to help out with another project - teaching kids in inner-city schools about sun protection.

"We just worked really hard to get to where we are today, and we've always set the bar high for each other," Katey notes. "Our parents put so much on the line for us, and that's kind of our goal - to, you know, show them all the sacrifices they made were so worth it. They're very proud."

Hannah and Nicole Rud
Creighton University School of Medicine
Hannah: Orthopedic Surgery
Nicole: Otolaryngology

Hannah and Nicole Rud look so much alike that the vast majority of their classmates, and their attendings, at Creighton University School of Medicine in Omaha, Nebraska, couldn't tell them apart.

There was the time when they were both doing rotations in labor and delivery, and a physician came up to Nicole and said, "Your patient's in labor."

"And I was, like, 'No, they're not.'" Nicole laughs. "'They're not even a centimeter dilated.'"

"Or Nicole would have worked with someone very closely on a previous rotation, and they'll see me in the hospital and say hi to me, and I'll just smile back," Hannah says. "And then it gets back to Nicole: 'Hey, why didn't you say hi to me the other day?'"

For their part, the sisters have never minded the comparisons. Both highly accomplished - Hannah just matched into orthopedic surgery, while Nicole matched into otolaryngology, two of the most competitive specialties in medicine - they nonetheless have forged their own paths.

Born in Brainerd, Minnesota, Hannah and Nicole are two of a set of triplets - their fraternal brother, Nathan, works as a project manager in Minnesota. They also have an older brother who's a practicing anesthesiologist at Indiana University in Indianapolis and two other siblings who aren't in medicine, though their dad is a retired orthopedic surgeon and their mother is a retired nurse.

"I remember when I was little, like, in elementary school, saying that I was going to be an orthopedic surgeon, which, obviously, I had no clue what that meant at the time. But I knew, from a very young age, that this is what I wanted to do when I grew up," Hannah says.

Both Hannah and Nicole attended Concordia College, a small, liberal arts school in Moorhead, Minnesota, and then both chose Creighton. "We applied to different places, but then both ended up choosing Creighton independently," Hannah says. "It kind of speaks to how similar we are overall and how similarly we think."

Come mid-June, though, they'll be in different states - Hannah headed to Corewell Health in Grand Rapids, Michigan, and Nicole joining their brother at Indiana University.

"We've never been apart for more than about a month at a time," Hannah says. "I don't think it's really sunk in yet. But we're only going to be four hours apart, so I think it will be OK."

Christian and Palmer Casteel
Christian: Mercer University School of Medicine
Palmer: Liberty University College of Osteopathic Medicine
Christian and Palmer: Pediatrics

Christian and Palmer Casteel took different paths to and through medical school, but in the end, they both found their way to the same specialty - pediatrics.

Growing up on a farm in Villa Rica, Georgia, with three other siblings, and homeschooled by their teacher mom, the Casteel twins grew up in 4-H, becoming camp counselors when they got a bit older.

"We just enjoyed working with youth, working with kids, and that kind of translated into pediatrics when we got into medicine," says Christian. "That, and we always loved the sciences and helping people at the same time, so medicine is kind of a combination of our interests and hobbies."

Despite similar interests, though, they decided to go to different colleges - Berry College in Rome, Georgia, for Christian, and Pensacola Christian College in Pensacola, Florida, for Palmer.

It was the first time they'd been apart for more than three or four days.

"It was a bit tough at first; our first birthday [apart] hit pretty hard," Christian admits.

But the brothers adapted quickly, and when it came time to apply to medical school, they found themselves selecting different medical schools as well.

"The most influential professors in my school very much promoted doing osteopathic medicine," Palmer says. He ended up attending Liberty University College of Osteopathic Medicine, in Lynchburg, Virginia, where he met his now wife, Jane. They did the Couples Match and will be heading to the University of Tennessee, in Memphis, for residency. (Jane will be starting her residency in emergency medicine.)

Christian had a similar experience, in that his school had numerous connections with Mercer University School of Medicine in Macon, Georgia. He and his wife, Sarah, who just finished a job as a referral coordinator at a nonprofit health clinic, will be moving to Boise, Idaho, for residency at Full Circle Health.

"I grew up in Georgia, did college in Georgia, and I'm on a scholarship [the Children's Healthcare of Atlanta Rural Pediatric Scholarship] that will have me come back to Georgia for four years after residency, so I'm, like, let's pick a place that maybe has more snow, or at least more seasons, than Georgia does," Christian says.

When all their obligations are done, though, the brothers hope to one day practice together. "One of our plans is to eventually work together and have our own clinic," Christian adds.

Julia and Sofia Steger
Florida International University Herbert Wertheim College of Medicine
Julia and Sofia: Internal Medicine

When Julia and Sofia Steger were 8 years old, they used to accompany their mother, a physical therapist, to see her clients.

"At first, I was mad, because what 8-year-old wants to go to a nursing home," Julia recalls. "But then we just made the best of our situation. We'd be bingo callers for them; we'd paint their nails."

"We saw how impactful us just being around them was to their well-being and their willingness to do exercises and physical therapy," Sofia adds.

That connection was reinforced when those same patients would spend Thanksgiving and other holidays with the family. "Our mother had such a special heart for these people, especially when they were lonely," Julia says. In fact, the pair declared at age 8 that they were going to go to medical school - together.

Of course, the journey itself was a bit more arduous. Julia and Sofia - who are two of a set of triplets; their brother Paul works in the contracting department for a locums tenens company - attended the University of Florida, in Gainesville, majoring in biology. Next up was medical school at Florida International University Herbert Wertheim College of Medicine, in Miami.

Identical twins who look and sound alike - and who often finish each other's sentences - they periodically considered going their separate ways. At every turn, though, they realized they were stronger together. "In medical school we were, like, 'We should get roommates,'" Sofia says. "But then we thought, 'Let's just see how medical school goes in the beginning.' And then we just loved living together and studying together. We understand each other so well."

They did all their rotations together too, which took some funny turns.

"We'd be in the psych ward at the VA, and a lot of the patients were admitted for psychiatric issues, and they would say, 'I know I'm crazy, but I'm seeing double,'" Julia says, laughing.

They even matched to the same residency, though they didn't go through the Couples Match.

Instead, they each put the University of Miami/Jackson Health System as their first choice for residency in internal medicine - though Julia plans to further specialize in oncology and Sofia will likely do a fellowship in gastroenterology.

"We're best friends," Sofia adds. "We always get questions like, 'Are you guys competitive?' And we always say, 'Not with each other. We just want the best for each other.'"

Aavaisra Ali and Kashmaila Ali
University of California Riverside School of Medicine
Aavaisra: Neurology
Kashmaila: Family Medicine

Aavaisra and Kashmaila Ali were born and raised in the Inland Empire (IE), one of the fastest-growing but most medically underserved areas in Southern California. The sisters remember visiting the free clinic next to the mosque the family attended, where members of the community could receive free vaccinations and other care from providers who looked like them and spoke in their native language.

"It was really great to see community members able to have access to health care when a lot of them were either undocumented or just didn't have insurance," Kashmaila says.

Later, both Kashmaila and Aavaisra volunteered at that same free clinic, just one of many times the pair assisted at medical clinics and hospitals during high school and college.

In fact, it was while attending the University of California (UC) Riverside that they began volunteering at hospice sites throughout the IE - and realized that medicine was the career path for them. "It was definitely a game changer," Kashmaila says. "This was our first time being exposed to a different side of medicine, where we got to see end-of-life discussions. We got to see patients at their very end, and we saw patients at their most vulnerable."

That realization fueled not only their path toward medical school, also at UC Riverside, but their choice of specialty. Kashmaila matched into neurology at Loma Linda University Health, while Aavaisra matched into family medicine at Kaiser Permanente Fontana Medical Center.

"It is truly one of the highest privileges I think anyone can have, being a doctor and treating patients," Aavaisra says. "Our parents are immigrants from Pakistan, and looking back on it, what we once thought was impossible has become possible for us."

The journey didn't come without a lot of hard work and sacrifice, though. The Ali sisters, who are two of a set of triplets - their sister Aimal works for the federal government - studied together and supported each other throughout high school, college, and medical school.

"Sometimes our family members didn't really understand what we were going through, but the fact that Aavaisra did, it made the biggest difference in the world," Kashmaila says.

Samantha and Alli Epstein
Case Western Reserve University School of Medicine
Samantha: Dermatology
Allison: Otolaryngology

Samantha "Sam" and Allison "Alli" Epstein come from a long line of medical professionals. Their paternal grandfather is a pediatrician, their dad is an anesthesiologist, and their maternal grandfather and their mother are pediatric dentists.

So, while they never felt any pressure to go into medicine, it wasn't terribly surprising that they found themselves on the premed track at the University of Florida. What was surprising was that they would end up at the same medical school.

"We really did not want to go to medical school together. We thought it was time to split up," Sam says. "But then we both visited Case [Western Reserve University School of Medicine, in Cleveland] and fell in love."

"It's a great school. We couldn't pass up that opportunity," Alli adds. "My next thing was, 'I'm not living with Sam. This is where I'm putting my foot down.' But our parents were, like, that's silly, you can share everything and you're going to be so busy anyway."

All of that togetherness ends next month, however, as Sam heads to the University of Pennsylvania for dermatology, on a pediatric dermatology track, while Alli moves to Chicago to do her otolaryngology residency at Rush University. (She also plans to do a one-year pediatric ENT fellowship after residency.)

"We grew up in a family of pediatricians and pediatric dentists, and we all just love working with kids," Alli says.

They have also loved encouraging and supporting each other throughout their medical school journeys. In applying to two of the most competitive specialties in medicine, they knew they needed to excel in research, academics, rotations, and interviews. And so they studied together, helped each other navigate their various research interests, and supported each other through all their clinical rotations.

"Being a twin, you're always worrying, not just about yourself - you're worrying about someone else too," Sam says. "I pretty much followed Alli every single rotation, and ultimately it pushed me to be even better. I was, like, OK, they expect a lot from me, because Alli set such a high standard."

After a while, they also entered most interactions by saying, "Just a warning - I have a twin sister," just to ensure that they weren't mistaken for each other.

That won't happen in residency, now that they'll be several states away from each other. But they also realize that they'll miss the closeness they have now.

"At the end of the day, we are best friends," Sam says. "We might argue for, like, five minutes, but then we're knocking on each other's door, like, 'So what are we making for dinner together?'"