One last thing to put this whole prestige / academic rank issue into perspective. One of the places I interviewed at is nationally renowned. I found it to be an outstanding institution with famous academicians, an awesome Chairman, and a top 5 rank in terms of NIH funding. Not only that, it is affiliated with a very good medical school, and as I was told on my interview day, ALL residents from this program who were interested in GI or Cards have matched successfully during the past two years. For this reason, I placed this school very high on my rank list...although it was not number one, it was in my top three.
Then, shortly before Match day, I read the following review on SDN, which was submitted by one of the program's PGY-3s:
"I would say the Achilles' heel in the program is the office of the program director. Many would use the term "unhelpful" in their relationships with her. With the caveat that I did not need a letter from her, I had several graduating seniors from last year complain to me that she did not know them and that their letters of support consisted of a few lines about their conference attendance records. Several of these people did not match and when they asked for her to call programs on their behalf, she did not do so. Recently, she sent an email out to the housestaff to discourage them from making schedule trades on call days because of the administrative burden it placed on her office. One outspoken resident emailed back that if we as housestaff are willing to cover for each other so that we can attend important personal events, secretarial time should be a secondary concern. I personally feel, for example, that my being maid of honor for my best friend's wedding should take precedent over a few hours of secretaries' time. There's also been some issue over a past intern who left from years ago whose confidential info was not so confidentially dealt with....... No inquiries, I'm afraid."
Needless to say, I was shell-shocked when I read this info., as I knew that there would be a chance that I could match into this program. For me, there is nothing in the world (e.g. most prestigious program, #1 ranked in this and that) that can make up for the things described in the review listed above. Having your program's support, honesty, and their being forthcoming, as well as your being happy at your particular program are the most important things when it comes time to commit yourself to a residency. If these vital things are missing, it will be a long three years, regardless of where you are.