To the OP: Tertiary referral centers including UTSW are the places that you should consider top on your list. As mentioned multiple times before these places provide you with great educational opportunities. There is not a significant different between these programs when it comes to education. I am pretty sure that the quality of education that you get at UTSW or any other big academic center is as good as MGH or UCSF or Stanford.
However, among these big academic programs there are two categories: Some have very good local reputation and some have national or even international reputation. I would put MGH, BWH, UCSF and Hopkins in a different level compared to UTSW or NW. UTSW will work very well if you are looking for a private practice job or even academic job in Texas, however if you look outside Texas the story is different. In any part of the country, local solid programs have a priority when it comes to getting a private practice job. Outside local program, only big names matter.
Let's say you want to get a job in California or Colorado. Graduates of local programs with good reputation (like UCSD, USC or university of Colorado) have the first priority because of all the connections. All the other programs to the local groups unless it is Harvard or Hopkins.
So if you have a real name brand in your rank list, I'd recommend you to rank it first. Put MGH, BWH, Hopkins, UCSF, UPenn, Duke and may be Stanford above any other programs. At the end of the day, the Harvard or Hopkins name will stay in your CV the rest of your life. After that, for ranking big academic centers, go based on location. For example, though personally I think UCLA is a better program that UTSW, if you want to stay in Texas choose UTSW first because of all the connections that come with it. On the other hand, even if you want to stay in Texas, choose UCLA over a small community program in Texas.
In other words, groups in Texas will like you because you went to UTSW and it has a good local reputation. However, no group in Florida or California or Denver will be impressed because UTSW has a big hospital or has lots of research money. They will either hire graduates of local programs or a graduate with Hopkins or Harvard name in his CV.