this is obviously a personal decision, but family always comes first in my opinion. I ranked my programs on a geographic basis, my first two were high-tier academic and3/4 were community shops. Did I feel like I was short changing myself by not ranking competitive programs more highly? Yes I did, but I knew my family would be happier. I would be happier as well because of that. And ultimately, we wanted to stay in this area after fellowship. It ended up working out that I matched at an academic place. But now that everything is over and I realize how busy fellowship is and how much joy it brings me to come home to my kids and SO after a busy day.... I can’t believe how much I stressed over my rank list before I submitted.For those who have to factor in Spouse/Family, how much do you weight Prestige/Quality of Training versus having to move to a new area forcing your family to readjust with new job, new schools etc for 3 years. Is it 50/50 or does one weigh one much higher than the other? I'm sure some of you are having a tough time ranking something that is lower tier but easier for the family as opposed to vice versa. Thanks for any insight
Let me say that this is also from the perspective of someone that wants to do general GI. If your goals are hardcore academic IBD, liver transplant, NIH-track research, etc, then yes you are probably better served going to an academic program.