Program name or operative experience. . . I remember going throught the same question. The bottom line is that you are not going through residency just to have an institution's name on your CV. Most of us would agree that when it comes down to it, we would rather be strong, competent surgeons. The operative experience varies from program to program. There are some big name programs with plenty of OR time as a first assist or primary surgeon and there are some that are lacking. Same goes for the lesser known programs. That being said, you don't have to operate a ton to be a good surgeon either. Quality can be better than quantity. Beyond operative experience, some argue that a good program name will get you better fellowships. Although there may be some truth to that, I think that getting a fellowship is based more on the individual and their credentials, personality, work ethic, letters of recommendation, and how you present yourself.
Deciding on your rank list is a difficult task. My suggestion is that you don't base your decisions on OR experience and name alone. Think about how you will get along with the residents. Ask yourself if they have strong resident lectures, whether the staff are engaging and dedicated to the resident's education, what is the call like, where have past residents done fellowships, how competent are the senior residents when the shit hits the fan, etc. You will be at a program for 5 years, so try to look past the superficial aspects of the program to decide where you will be the happiest.
