Hey guys. So I can't believe I'm making one of THESE threads, but I am torturing myself over this and need some input. CLIFF NOTES: Choose better training, or likely better job-placement. Place ONE: - training will be perfectly adequate, nothing special but above average - but - jobs/fellowships lined up in October of third year because they started getting letters from various groups and EDs in July. - all picking and choosing between multiple dream offers. - Strong record of groups who recruited a resident one year then hiring over and over from the program because they are so pleased. vs. Program TWO: - phenomenal training in a trial-by-fire ED - tons of autonomy and procedures -but - job placements kind of blah - many pro-actively sending out tons of CVs, cold-calling, getting 3rd and 4th choices. DETAILS: *I am NOT going into academics, fwiw. I am torn between two programs, both incredible, but differing in one or two important areas. I did an away rotation at both of these places. Program ONE is a usn&wp "top 5 medical school"/"top 10 hospital" with a respectable but not phenomenal EM program (way overshadowed by Medicine, Surgery, and multiple sub-specialties). They send about 70% of docs to community, 30% to academic, despite being located at a research powerhouse. I really gelled with the residents there. PD is incredible. Location is a B+. Program TWO is a community hospital in a lower-income community. It is well-known only in EM circles because the EM program is the most powerful in the hospital and the place is basically run like a county hospital. About 90% community and 10% academic. Loved the residents and PD. Location is a C- . Having spent a month in each place, I am absolutely certain the better program as far as pure training is the program TWO. Unreal amount of procedures, insane autonomy, almost NO consultants available. Problem with program TWO is--despite the reputation in the EM community--it has a sad-looking "where-our-residents-are-getting-hired" list, with many residents having to cold-call, sending out tons of unsolicited CVs, getting jobs they are disappointed with, etc. Program ONE, on the other hand, offers a great ED culture with middle-tier but happy, friendly residents. But the "...-hired" list for this program is unreal. Residents all had jobs/fellowships lined up in October of third year because they started getting letters from various groups and EDs in July. Everyone picking and choosing between multiple dream offers. Strong record of groups who recruited a resident one year hiring over and over from the program because they are so pleased. Obviously the training at Program ONE is good enough to have an unreal job placement profile, but I know my training at Program TWO will be more hardcore, more autonomous, more complete. I kind of feel like choosing ONE over TWO would be selling out, which I know sounds childish. But, if in the end what I care about is landing that dream job, what good are all the bells and whistles of the hardcore place? I'd appreciate any thoughts or advice. Thanks in advance.