Hi there,
This is what is boils down to: Don't rank any program where you would not want to do your residency. It makes sense if you are interviewing for a competitive residency to have some programs where you are competitive (I am talking numbers) but you should not have programs that you don't want to attend but are thinking that you are a "sure thing". Accept interview at places where you know that you would want to be.
How do you make sure you want to be at a program? Just because a program is "nationally-ranked" does not mean that it is the program for you. Name and reputation are meaningless if you are a miserable human being. Talk with your department chairman and program director at your school. Show them your numbers and your invitations. Let them advise you in terms the places where you have a shot and where you can get good training. Talk with residents at your school and find out where they interviewed and what they think.
Finally, make your rank decisions on more that what you see on interview day. Many programs will only show you what they want you to see. Go back on a day outside the interview, to the programs that you really want. This is impressive to the program directors anyway and will improve your chances. It is even better if you can spend a complete day and really see the program when the stress of the interview is off. Look at the housing situation too!
If you wind up matching where you are miserable just for the sake of matching, you have a job that you hate every day. Residency interviews are very different from medical school interviews. You are interviewing for a job with a company. They are looking at you as strongly as you are looking at them. Have some good practical questions to ask and good luck.
njbmd
