Wow, you got up at 4 am *voluntarily*? That is just unfathomable to me. I wish I could channel my excess anxiety into cleaning and such, but it seems the only way I can occupy myself is to obsess over decisions (don't think closet cleaning is going to cut it there).
Speaking of, I made one! Look at me! I really appreciate all of your input - you all had some excellent points and it helped me put things in perspective. I ultimately decided to go with the leadership course, because it was clearly what I WANTED to do. The ICU course is so popular, I am sure there is someone who is thrilled to have my spot, and I feel much better about it going to that person than to good old ambivalent me. And while there are certainly potential benefits to doing some clinical work closer to residency and getting some ICU exposure, they just didn't outweigh for me the desire to do something different, to have some down time for myself and my family, and the internal groan that surfaced every time I thought about getting up at 5:30 to go to an adult ICU. Bleh. (No offense Emily!). So there you have it. I decided, and I feel much better about it now.

Okay, quick, give me something else to obsess over, so I don't revert back to my rank list!