I recently graduated with my BS, and have applied to a few PhD programs this year. But I doubt I'll get into my first choice this tume around. Would it be better to work for a year and reapply, or should I just go where I get in?

Obviously no one but yourself can answer this, especially as we do not know anything about your options. The way I reasoned was that I would start applying only to my favourites. Luckily I was accepted by my first choice, but if I hadn't had the opportunity to go somewhere I really wanted to, I would have taken a gap year to think about things and get more experience. Then I would decide if I wanted to do a PhD even though I couldn't go to my preferred lab. If yes, I would start applying to a broader range of positions. But of course this is the strategy that I thought would work the best for me - you will have to decide on your own. Good luck!

My first choice is a program through NIH to study at either Cambridge or Oxford, and do some research at NIH headquarters in Washington DC. I've also applied to Emory and Tulane. They are both very good programs, but can not compare to the prestige (and coolness) of a degree from Cambridge or Oxford, with experience working for NIH at some of the best funded and equipped labs in the world.

Just out of interest, how long did it take you to decide how great Oxford and Cambridge are? Sounds as though it may have been in the order of 22 seconds. Perhaps you got that idea from a book you read whilst in the Far East? Sounds informed either way though.

Well, the decision probably could be made pretty quickly, but I spent about two hours each reading up about their biomedical sciences programs, and the projects currently offered by NIH through these schools. NIH itself is a huge pull, I have done internships at one of their primate research centers, and find that research just works much better with adequate funding. This program, aside from being cool, also guarantees that you and your advisor won't spend your entire time attempting to get grants funded, which makes the whole process that much better. So no, it wasn't just a spastic decision made on the spur of the moment.

I would have waited I think but I got my first choice. I did accept my second choice and then did not continue once I got my first choice though. It was all about having options for me. This is 3-4 years full time or 5-8 years part time of your life. I would not have been able to cope with the demands of a PhD if I were not passionate about the topic, people or university. You need to have the right mix. This includes the perceived prestige you associate to a university/lab as well.