I have coronary ramus artery occlusion. The md wants tomanage it medically rather than putting a stent. Your opinion?

Stent. You should ask your doctor to explain the therapy of CAD and when procedures like stenting are indicated and not indicated. The presence of the occluded ramus does not necessarily imply stenting is indicated.
Depends. Optimal medical therapy recommended regardless. If area supplied by this artery is fully damaged/scarred & you are not having symptoms then revascularization or stenting is not indicated. If symptomatic, a trial of medical therapy for symptoms is recommended. If symptoms continue despite medical therapy, option of stenting vs. Bypass surgery should be discussed further with your cardiologist.
Chest pain? If you have chest pain, then stent will relieve it. If you have no symptoms, then medical management is now considered perfectly acceptable. That means optimal blood pressure, cholesterol & sugar plus aspirin, healthy eating, regular exercise & normal weight. Feel free to get 2nd opinion (not just mine) from another cardiologist (in different practice).