this really depends. if you're img or fmg with not much in your cv, you rank as much as you can. if you're an average amg with nothing bad in your app, you will most likely get in your top choices as long as your not limiting yourself or selecting only top tier places. i was told to not rank a place if you see yourself very unhappy as a resident at the program. i didn't rank 1 program because the residents at lunch during the interview told me they really hated it. like 4 of them and just me at the table. i don't know where the other candidates went. maybe they left early. i hope the residents weren't pulling my leg. they were so consistent that it almost seemed like a conspiracy. but the hospital wasn't that great anyway so they were probably telling the truth. to sum it up, only rank a place you're not comfortable with if you're desperate. well, that's basically what sluggs said.