My advice is simple: Almost all surgery residency programs are good, but not equal. Do you want to do research? Yes = academic program, Maybe or No = academic or community. Easy. Geography---this one's self explanatory. Competetiveness--to be serious, if your step 1 score isn't much higher than the mean with an average application (whatever that means), don't plan on getting many interviews at the big academic/research programs (Duke, UCSF, Mich, WashU, Hopkins, UCLA, Brigham, etc). It's just a fact-though you may have a 'shot'. Do you want a county hospital or VA experience? This narrows it down. Do you have a family--a major consideration. USNews's hospital rankings--some people actually care about this kind of thing! It happens. Reputation of the program--go to the faculty at your school and ask--even ask attendings you haven't worked with, they may have interesting comments. Start to put all of these things together and you will easily be able to narrow your list down to 20-30 programs. Hopefully. My 'best' program was one with a great reputation among faculty, incredible residents, no mandatory research but with a very strong research component, a county hospital, VA hospital, Children's hospital, and in a city larger than 500,000 that had a lot to do outside the hospital (despite my lack of time)