It seems you don't know much about HMS since you're from the west coast, let me help you out. HMS' main teaching sites are BWH, Children's, Beth Israel, and Dana-Farber (all within a block or two of campus). It would be preposterous to not include those. There are some students at HMS who never even step foot in MG. MG could be included in the list too, but it's not in Longwood and just as many students rotate in the other listed hospitals as MG. HMS has CLEARLY been leagues ahead of every other medical school for centuries. They are 100/100 by USNWR and have received a perfect score in literally every single edition (whether it's a research, peer rank, or MCAT heavy methodology year). Most years, the #2 school (whether it's Hopkins, UCSF, WashU, Penn, or Stanford) is ~80-85 out of 100. The difference in the 2019 ranking between #1 HMS and #2 Hopkins is same as the difference between #2 Hopkins and #22 UC San Diego. HMS is, and always will be, in a league of it's own. I agree that'd it'd be silly to go to #1 over a Penn full-tuition, or hometown Stanford/UCSF just for the ranking, but let's not pretend HMS isn't in a league of its own. HMS is ranked #1 in all 7 of the specialty rankings. No other top 10 besides Hopkins (which has one specialty tied with HMS) and UCSF (which has 2 top 3's) come even close to that.