Yeah, that was my concern, but the benefits seem to good to pass up: Dedicated research time/time to acquire a second degree, more time to study for Step I if you need it, more time to figure out what specialty you want to do and plan the appropriate electives/away rotations, etc. From what I have been reading, it seems that those schools that have a reduced pre-clinical curriculum have a slight edge in terms of having time to do electives needed for their specialty before submitting the ERAS. That's just my opinion, though. A current Duke Med student will probably shed some light on this issue. My only other issue with Duke is um..Durham. Maybe you can shed some light on that YNK?