As I progress through my intern year of general surgery, I try and help the 4th year students at my current institution with applications, places to apply (and not to apply), and what to REALLY look for in a program. I thought I would drop a little of this here on the forum. I think as an applicant I often looked at the call schedule, the case numbers, community vs. academic, fellowship matching potential, how the residents got along, and how much they saw the O.R. prior to their 3rd year of residency. There were other things but they were more specific to my situation (married with a kid). So, what's really important. I have to say that fellowship matching should be at the bottom of your list (although some will disagree). No matter what program you come from, matching into any fellowship of your choice (other than pediatric surgery) can be achieved at any program. You can go to BFE in southeastern illinois for GS and still match at Baltimore Shock for Trauma. It happens all the time and is not a rarity. At the top of your list should likely be AUTONOMY. There are so many programs where you don't ever see an attending except for the "critical parts of the procedure" while other programs have an attending hovering over you when you put in a central line. Community programs tend to be have a little more hands on from the attendings (cuz they get paid more for the procedure if they are "present and scrubbed for the entire case") while academic programs for the most part are hands off. This is a generalization but you need to ask these things on the interview trail. What do I think is best? Well for your first 3 years, it's nice to have the attending hovering over you, critiquing your moves, and giving you input on how to improve. But for the 4th and especially the 5th years, hands off is definitely better. So a graduated level of autonomy is probably best. I can't stress autonomy enough. I felt that my medical school program was very hands off while my residency program is too far on the hands on side. Call schedule and hours will be of very little concern overall if this whole 80 hour work week is solidified. BTW, there is a HUGE difference between q2, q3, or q4. How the residents get along: Extremely important. You can usually see/feel this interaction during the interview. You have to work with these guys for 5 years. Getting in the O.R. during your intern year is icing on the cake. You tend to get really bitter if you go into a specialty and you don't even get to practice the type of medicine you want. I've done 2 solo lap choles, 1 lap appy, a modified radical mastectomy, and some other basic cases in my first month and half. This helps you remember why you're staying at the hospital >100 hours/week. Anyway, there's other stuff and I'll add it if wanted but you get my drift. There's more to a program than what's on FREIDA and it's extremely difficult to evaluate in a one day interview.