You should rank how you want, do what you feel. I think it's not for everyone. I ranked another middle tier program above them for personal reasons and for fit. Realistically I probably had no chance of matching there, but I also think I would have been overwhelmed by the sheer work of Bascom. I don't know if that's good or bad, just different. I do think that though you are thrown into it at Bascom the support system is excellent and the upper levels and fellows are incredible at teaching. They seem to be well oiled machine.
A few things which you probably already know...Bascom is a serious door opener and the training is great. I got the impression they do a lot of procedures in every subspecialty. I've noticed that some of the average middle tier programs have domains or weaknesses when it comes to that. Like they wish they had more of XYZ. Their didactic and lectures are excellent and their PD really cares about their well-being. Though 1st year seems super challenging, it gets way better from there and everyone seemed to be happily surviving.
If you end up doing comprehensive with no fellowship I can't imagine you wouldn't be prepared by Bascom. I've also noticed that many people want comprehensive and still do 1 year fellowship for job opportunities and a little extra. It seems after fellowship many of the Bascom grads are in private practice. So I don't see how it could hurt you if you wanna do comprehensive... Both for training quality and getting jobs.
But I do understand what it means to feel you fit somewhere. That part is all you. If you break it down Part of it is personality, some state of mind, also adaptability and where you are in your life. It's ok to have different priorities than others. I know people who went through with kids, while many are single. But they also have their life outside of residency and didn't need to have social time with residents. If I put myself in the spotlight...I brought my significant other to residency to a place neither of us had ever been. And we've done whatever we have to though residency with a committed relationship takes sacrifice and hard work. I've moved all over the country and would have gone anywhere for residency. However, I met many people who are terrified of leaving their region for one reason or another. Or who have very specific needs. I have met others who are miserable in certain places and never anticipated it, causing them distress. It's all legitimate, but everyone is different. I could seriously talk for hours on scenarios like this, but I think I've made my point.... It's about you...
Ultimately it's your choice and you know yourself best. Trust yourself. If you feel you will be unhappy at Bascom or you didn't like the vibe then don't rank them #1. People have a habit of perseverating on their rank list and sometimes use it to fuel unhappiness in their program... Ie: "if I had thought this through I'd be at that other program instead"... That is obviously an unknown, but people love to wallow in that fashion, so rank how you want with no regrets.
