It really depends on the geopraphic location, if the internship is done at the same hospital as the residency or at a community affiliate and the composition of the internship. If the internship is at the same hospital and has a good mix of rotations where you're not getting slammed with call all year round, then the 4 year program will probably be more competitive. If the internship is a grueling year of internal medicine and there are many nice transitional year programs in the area, then the 3 year program may be more competitive. With this said though, these can often change year to year and really depends on the specific place. Some places just ship you off to a community hospital in the area and you never step foot in the hospital you are going to do residency in. It's very variable.
Cornell has 8 spots reserved for the categorical 4 year program. The rotations are very well set up for a career in anesthesia/critical care, and while the schedule might not be as cush as some transitional programs at community hospitals, it is definately very manageable, a great learning experience as you rotate through 2 world class institutions, and you get the excellent housing without having to move after your first year.
1st year rotations are as follows:
15 weeks of ICU at Memorial Sloan Kettering (pretty cush compared to other ICUs)
9 weeks of electives, your choice at either hospital
6 weeks of medicine at New York Hospital/Cornell on pulmonary step-down unit
6 weeks of thoracic surgery at Memorial Sloan Kettering
3 weeks of hepatobiliary surgery at Memorial Sloan Kettering
3 weeks of ER at New York Hospital/Cornell
3 weeks of PICU at New York Hospital/Cornell
3 weeks of NICU at New York Hospital/Cornell
3 weeks of vacation
Feel free to ask me any questions. I am very satisfied with my training here.
This years PGY-1 class is from a variety of schools, Harvard, UCSD, Tufts, UVA, BU, Cornell, UF etc, who are all strong candidates. Everyone is laid back and easy to get along with.