What do I pick? Offered CVICU at a small community hospital or medsurg at big Lv1 teaching center? Goal is to work at Lv 1 teaching in the ICU.

Get your foot in the door at the level 1 trauma center

I would do CVICU and get that experience and then move on to level 1 into whichever ICU.

Take the teaching facility hands down! Those opportunities don’t come around forever. You’ll have mentors there, teachers/faculty and other’s in training too.
There’s little education if any going on in small hospitals. Huge difference.

Always take the ICU, if it’s available and that’s where your heart is. It can be busy and quite taxing, but the education will be unparalleled and it will last the entirety of your career.

CVICU for sure. You’ll gain invaluable experience at a smaller hospital and will be more confident moving into a trauma I.