SoCalRULES!!!!! said:
NY, LA, SF are the three first tier cities to choose from, which draw people from worldwide (both incredibly affluent to impoverished). These are the three culturally vanguard cites in the US, with LA and NY being a solid step ahead of little sf)
I guess if I guy that calls himself "SoCalRules" with five exclamation points says Chicago is not tier 1 over and over and over again... then it must be true in his world!

Now I am convinced you are doing it on purpose though since no human being can possibly claim that the first tier cities are New York and LA and then put in San Francisco (population ~800,000) without evening mentioning Chicago (population ~3,000,000) especially after everyone totally ripped you a new one in that "urban med schools" thread (including people from DC, NYC, etc.)...
There is no way around it.... no matter how much you want to ignore it, Chicago is a Tier 1, completely international, diverse as ****, cultured as all hell, very important, world-class city, that would be in your OWN BEST INTEREST to learn about if you want to become more cultured and well travelled.... ESPECIALLY in medicine considering that the AMA, American College of Surgeons, The Radiological Society of North America, The American College of Orthopaedic Surgeons, American Osteopathic Association, and I'm sure there are many that I'm forgetting off the top of my head, are all headquartered there.
Welcome to my ignore list anyway though... you have now proven yourself to be completely unwilling to learn anything about actual cultural realities, of your own country no less.
I leave you with this...
http://en.wikipedia.org/wiki/Global_city
...read and scroll, paying close attention to the cities they have pictured.
...and this...