Do you think the prestige of MGH/Hopkins is worth anything in a tight job market versus UTSW? Assuming you want to end up in North Texas doing private practice once you finish up your training.
No. If you leave Texas to go anywhere you will have an uphill battle getting back into the state to practice, competing with people that have not left and have proven they have no tendency of leaving. This goes for just about any state/area. My friend of mine who left Chicago for UCSF and now can't get a job in Chicago, while I know of many people who have stayed in Chicago have gotten jobs there, is just one of many examples I can think of. A practice will always look first and foremost at people who are rooted in the area and who have as little chance as any to not leave and mess up their practice.
I wish medical students would really think this stuff through, though in retrospect perhaps I didn't have someone who gave me this advice. But listen, this isn't college we are talking about here where you can just move back so easily. You are going to have to find a job after all this is said and done. I don't mean to be offensive so don't take this the wrong way, I'm just trying to help, but do medical students really believe that you will be able to read a CT or MRI that much better at one program over another? Do you believe attendings think you are "prestigious" and will pay you more when the RVUs are all the same for all of us? And that private practices actually care that you left the state and think you are hot **** and want to come back again? These things will HURT you--not help you. I can say as an actual attending that no one is impressed. Being a 4th year medical student, are you impressed where your fellow medical students went to college? Think about it.
Now, the flip side of this is if you want to practice in the Northeast, there is no question you should go to MGH. But if you want to practice in Alabama you should go to UAB. If you want to practice in Minnesota you should do everything possible to be at U of MN or Mayo. If you want to be in Arizona you need to do anything you can to match in Arizona. Etc. Etc.
You know what is the ultimate prestigious amazing CV? You are born and raised in the area and stayed in the same region or state for medical school, residency and fellowship, where everyone got used to you. The people at your program really love you and think you are a nice person, reliable and a hard worker, and most importantly they know the guy personally who owns the practice where you are now interviewing for a permanent job, and they can call him up on the phone and tell him as much. And you have a wife from here too. And your whole family is here. And you guys have a mortgage and a kid attending school and not only have no plans on leaving, you wouldn't even think about it. That's the ultimate CV.
This is a small world where everyone locally knows everybody locally, and every good PP job is one that is not advertised and where someone knows you. I remember interviewing at the most prestigious places in California and they were dead honest with me that they had no connections to any groups back home, and you need to listen to real advice like this. Because "rankings" are not real and exist only on Internet forums among medical students. The real life of leaving where you want to eventually get a job only to start all over again from scratch cold calling a bunch of random groups and hospitals that haven't heard of you and don't know the attendings that know you, and fight your way back to the state you already left all the while competing with known quantities who are already there and interviewing for jobs, is a fool's game. It is possible, just as anything's possible. It just won't be easy.