I'm a current TY resident at Grand Rapids Medical Education and Research (GRMERC) in Michigan. I would seriously look into this program. Our program is pretty laid back: 2 mos IM floors, 1 ICU, 1 cards in-patient, choose 2 of 4 from either peds, family med inpatient, surgery, or OB; 1 month of ER, 1 outpatient month call free, 1 elective with call and 3 electives call free. Most of the TY's I've talked to are happy with the program and they really make a concerted effort to make you feel like a part of whatever service you are on that month, rather than a glorified med student/ scut monkey. The only drawbacks I could think of are that: 1. Grand Rapids, MI is no Chicago or NYC (but is still fun when you want it to be) and 2. Getting your ass kicked with more floor months in other prelim. programs may not be entirely bad for you in the LONG RUN since, as anesthesiologists, we are "the internist of the OR." Of course, the anesthesiologists in this post who are in the "real world" would have more to say on that matter than I would. Something to consider. Hope this helps.