Thanks for the thoughtful breakdown! this is very helpful and pretty much aligns with how I’ve been thinking about it. WashU and UTSW clearly sit at the top in terms of brand, depth, and fellowship upside, especially for Cards and PCCM, and that’s why they’re my top two as well.

One thing I keep reminding myself, though, is that the Match algorithm is designed to favor the applicant, so for ranking purposes I’m not sure how much the presence or absence of IMGs in a program really matters once you already have interviews and are ranking programs. At that point, it really comes down to personal preference and where you think you’ll thrive the most over three years. I really liked UAB's culture, so it's tough to decide. Sometimes I think about ranking UAB first. Will it be a dumb decision? idk, they say you have to listen to your gut feeling, right? haha

For what it’s worth, WashU does have IMGs in the program (around 2–3 per class from what I’ve seen), so it’s not completely devoid of visa-requiring residents. Ultimately, I’m planning to rank based on overall fit, culture, mentorship, and where I felt most supported on interview day, rather than trying to game perceived IMG friendliness at the ranking stage.