I am not a TX resident and I sure did pick Baylor over Harvard!
Why? The top 3 reasons (order changes with the hour):
1. Texas Medical Center. Biggest in the world. Huge public and VA hospitals (i.e., lots of hands-on experience). Big Spanish speaking population. Lots of specialized care. People fly in from all over to receive care here. Plus, TMC grows every day...
2. Baylor's feel. Baylor is very open to people from a wide variety of educational and life experiences. (This is an intensely personal thing--I did not want to go to med school in a place where more than 30% of the students in each class come from either Harvard or Yale. Not that this is a bad thing--I went to Harvard as an undergrad, too--but I feel it is time to move on.)
3. The Deal. Let me explain: As a student at Baylor, you have access to TMC, which essentially means that you can learn whatever it is in the world that you want to learn. You finish preclinical in 1.5 years, which means you have 2.5 years to do rotations. So before you go off to residency interviews, you can do electives and a sub-I in whatever you want to do. Also, Step I of the Boards is not a requirement for promotion, which means that you can do a few key rotations before you take the boards, which can improve your score. (Both the increased amount of clinical experience and the higher board scores will lead you to a better residency placement.) You can work with many big name specialists here in things ranging from surgery to nutrition. And you can leave school with little to no debt, which will give you the freedom to do whatever you want in the future without fear of your ever-increasing loan load. I will leave Baylor with no more than $60K in debt. I would have left Harvard with at least $212K in debt. This is a huge difference! And it would not have afforded me any better opportunities than Baylor will.
Also consider why schools in the top 5 are in the top 5--NIH funding? Faculty-student ratios? Residency director rankings? Percent accepted (or not accepted)? Which reasons are important to you? Which are not? I think Baylor takes a big hit in the rankings because of the fact that it does accept some students with lower stats (many reasons for this) and because about 1/2 of the students elect to stay in TX for their residencies, so some residency directors are less familiar with Baylor students. (This does not prevent people from matching in top residencies in the really tough specialties!)
I have a friend who is a resident at a Harvard-affiliated hospital. He says repeatedly that the med students who are great at HMS would have been great regardless of what med school they went to. The ones who need HMS are the ones who aren't great. I think this goes for most of the top 5 schools. (He and ALL my other resident/physician friends encouraged the Baylor decision. I mean, each and every person.)
Now, it would be a HUGE lie to say that it wasn't a tough thing to give up. But on the "pros" list for Baylor was longer and more passionate than the one for Harvard. And it is not a decision I regret.
And, you know, I only have really good friends here in TX. If you threw my mom and dad and grandmother into the mix (unfortuantely, they are in Boston), there is no way any school other than Baylor would have even been on the radar!
Good luck!
mma