I'm really torn also, and I'd love people's opinions on where I'm wrong/crazy/blowing things out of proportion.
The two things I'm looking for most in a program are diversity of practice approach (to learn all the drugs/techniques with the freedom to practice using them) and progressive responsibility (have to be able to stand on my own by the end). Academically oriented and near family in Boston/SF Bay area a plus. I might be interested in cardiac and/or critical care fellowships down the road.
I'm pretty comfortable with my #4 Duke and #5 Penn, but my #s 1-3 are so close that I could easily rearrange them however. Every one of them has great and merely good attendings, and good resident camaraderie. Thoughts on strengths/weaknesses/ordering is very much appreciated. I hope I provided people looking at these schools with good information as well!
My top five programs, in rough current order:
1. Brigham
Pros: A friendly Harvard. Strong community, very supportive. Pretty strong cardiac, ok CC, reasonably strong in all areas (though no liver txplants). Dr. Lekowsky is relatively new, but has made big changes and is very supportive of the residents. Massive revamping of program due to recently-lifted probation, including protected didactics time, but long-term fallout not yet clear. Nicest facilities (though building arrangement strung along Francis St. is annoying), particularly the cardiac area. In-house intern year, possibility of transferring to med-anesthesia program if it's up in time. Pre-op clinic well-developed compared to many institutions.
Cons: Resident told me that several years ago, about 1/4 of the senior class failed boards. No CRNAs, for all the good/bad that entails. To make up for no CRNAs and shrinking class size, went on a large hiring spree recently of their own graduates; concern is a too-inbred, homogenous approach/education (there's a 'Brigham way'). New attendings have a reputation of being clingy, and not letting residents grow to independence as well. Less academically-oriented, less cool (though commensurately cheaper) area of Boston. Command-line ordering system. Categorical internship is a hard year with a lot of medicine (though probably excellent training given Brigham's IM rep). Developing it's regional program (though strong in pain). Department chair is something of a space cadet, much more interested in research and he and some attendings are 'passive' and reportedly not strong advocates for the department/residents. Splits catchment basin with many other hospitals, though status as quaternary care center helps. Unionized nurses, which seems to be a problem at the NYC programs at least.
2. Stanford
Pros: One of my first thoughts after was 'the complete package'. Friendly program with lots of early independence and diverse practice, and one of the foundational programs in cardiac surgery/anesthesiaGreat integrated med/surg ICU model. They claim their acuity/case mix index is highest in nation. Drs. Pearl and Macario and the rest of the administration are very friendly and supportive, receptive to my research ideas. Connected with undergrad/grad schools/tech industry has the potential for interesting collaborations. Weather a big plus for my SO. Has a med-anesthesia track and strong research track.
Cons: SO and I would love to live in a city, and south Bay area is like a huge suburb with city-like cost, fewer job prospects than a major city, and the possibility of having to own two cars and commute in opposite directions. Not as near nuclear family as Boston programs, which might be a drag intern/CA-1 years. New hospital of which I'd see all the traffic/construction and none of the benefit. Few CRNAs, for all the good/bad. Few categorical spots in-house, loose association with SCVMC. Developing its regional program.
3. MGH
Pros: Man's Greatest Hospital. Most academically oriented faculty and residents, huge roster of top-flight field-leading research and caseload (eg neurosurg under MRI guidance). Probably more diverse practice than Brigham (but there's still an 'MGH way'). Lunder building has a bunch of nice new ORs. Strong didactics. Dr. Baker is a fantastic PD, strongly resident oriented and an excellent educator. Dr. Charnin is a slightly odd duck, but incredibly helpful/supportive. Reputation as 'best residency', fwiw. Best CC training in Boston, if not the country. Army of CRNAs, for all the good/bad that entails. Ranking system to request rooms several days in advance. Incredible history, amazing to be a part of it. Program has made a substantial effort to reach out pre- and post-interview.
Cons: More of a workhorse/'deal with it' program by reputation. Besides Lunder, less nice facilities. Semi-integrated intern year at NWH is easier but far from campus. Staggered start could screw you over for fellowships down the road, though less likely now. Walked in hoping to be blown away, expectations were disappointed by merely really liking it. Developing its regional program. Wasn't a huge fan of the department chair after meeting her briefly. Splits catchment basin with many other hospitals, though status as quaternary care center helps. Malignant cardiac surgeons make for an unpleasant experience, reportedly. Recent large expansion of CRNA staff to deal with quality of life complaints by residents has caused friction internally, some feel CRNAs have been rammed down their throat.
4. Duke
Pros: Loved the program organization and philosophy. Intentionally small class sizes plus mostly owning a huge catchment basin means incredible education opportunities. Lots of CRNA's, for all the good/bad that entails. Excellent cardiac and regional, and very good critical care training. Dirt cheap cost of living means living large on a budget. Very pretty facilities. Incredibly kind and supportive staff. Has made the biggest effort to reach out pre- and post-interview of any program (they're clearly a top-tier institution struggling with attracting candidates due to location).
Cons: Sort of the anti-city, though space and low cost of living help offset this. Fewest job opps for my SO. State politics disastrous. Farther from family than my other top choices.
5. Penn
Pros: Dr. Fleisher and Dr. Gaiser kind of make the program- incredibly kind, supportive people with extensive connections. Excellent cardiac and critical care teaching. Lots of independence and diversity of practice. New-ish surgi-center across the street and new cardiac rooms. Integrated TY year, mostly at a nearby affiliate but well-integrated into department. Moonlighting policy means significant bonus income available. Philly is a pretty decent city, and very cheap for what you're getting. Building up its research arm which benefits from Penn's research generally, good research track available, academic orientation means intense caseload of interesting/insane cases (all the TAVIs you want, for example). Lots of excellent young faculty, often hired from within (similar pros/cons as for Brigham).
Cons: Old-school hard workhorse program (though monlighting pay eases the pain) combined with few CRNAs (all the good/bad, etc.) means a non-trivial low-acuity/low-yield case load. No pre-op clinic, residents hand-write short pre-ops from surgeon's outpt notes. Lots of stodgier old attendings. Developing its regional program. Resident told me OR management is not good. You never quite know when you'll get out in the afternoon.
Sorry for the wall of text. Your thoughts and opinions are very valuable, thanks!