I know you'll probably read this and say, "Well that wasn't helpful at all...". However, as someone who applied last year and already muddled my way through a rank list once, this is what I have to offer:

It's a 100% personal decision, and no one can make it for you.

Some things to consider...

- Where would you rather be geographically? This refers not just to personal ties to one area or another, but also to weather (do you want to have to dig your car out of the snow at 5 am or worry about hurricanes?), availability of public transit, and what each metropolitan (or otherwise) area has to offer (if you like to salsa dance, maybe Cleveland isn't the better place for you).

- Cost of living. For example, Penn and Geisinger have the same salary...In Danville (Geisinger) I could buy a 3+ bedroom house with a yard for my dog, and in Philly I could buy a roomy cardboard box. Granted, this should not be your number 1 concern, but it may be something to think about.

- Rotation set-up/availability. Do you get bored easily, and thus would six-week rotations suit your style better than 3-monthers? Or would you rather really solidify your knowledge with a longer stint on a service? Do you have to travel a lot to other hospitals for certain rotations? This happens sometimes with things like Peds, Trauma, and Onc. Even if the program pays for housing, etc., traveling can still be a weary pursuit. Is there a subspecialty that you're considering which might not be available at one place, or to which you'd get only limited exposure? (Onc, F&A)

- Are there other factors that attract you to one program more? Research resources, big name surgeons, Big 10 football...whatever it may be, you're going to be working long, hard hours for the next few years, and you need to consider the accessibility of everything that may add another bright spot to your life.

All that being said, I did not apply to Miami, so I don't know whether their program differs from Case in any of the above ways (besides the weather). Think about it, make a decision, and don't look back. The system has a funny way of making sure you wind up in the right place.

Good luck!