Rank List Due!

On Feb 22, I have to put in my match list for residency. If you are familiar with the "Match", skip to the next paragraph. If you aren't, let me sum it up by saying that a med school graduate is obliged to spend thousands (sometimes 10s of thousands!) of dollars traveling the country and interviewing at usually more than a dozen schools to improve the chances of a favorable match. On March 16, I'll get an envelope along with everyone else in the country who is graduating from medical school, and it will tell me where I'll have a job starting in the summer (ie. where I've "matched"). The whole thing shakes out by having applicants and programs make a rank list of their prefferred employer or employee. Someone flips a switch on a computer somewhere once the data is gathered and it spits out all the results.

So, the question facing me is where I want most to be spending the next few years. I have to have my rank list in by Feb 22 (3 days!), and we're still having some question about where the best place will be for our family. So, please advise!

The first choice we have to make is for the transitional year that will start this summer. It's a one year program that bridges medical school to advanced training in a subspecialty. The top three choices are Chattanooga TN, Canton OH, and Akron OH. The pay is better in Ohio, but the cost of living is higher too. The three programs all have a good educational program, so we could be persuaded in any direction.

The second choice is how to rank the advanced programs (radiation oncology). The top three choices are University of Iowa, Roswell Park Cancer Institute, and Cleveland Clinic. Which criteria is most important, the educational environment (quality of training and job prospects), the work environment (the day to day tolerability and comfort of my next 5 years), or the setting (weather, cost of living, already own a house and like Iowa, proximity to family, etc.)?

Further, should I rank the poor radiation oncology programs at all? It's really competitive and I may not match at all given that I applied to over 60 programs and got only 6 interviews. It turned out I discovered that 2 of those 6 programs had major problems when I interviewed there. One I won't rank at all for sure, but the other one I'm ambivalent about. It doesn't have a strong program, but I could possibly endure 5 years of a poor program if the alternative is to not have a job in the specialty I want at all. If I rank it and I end up matching there, I'm contractually bound to accept the position, so it matters whether or not I rank it.

Anyway, if you have any thoughts or insights that might be helpful, please let me know!!!

Thanks!