I would NOT suggest you attend WashU for medical school if you want to do primary care. They do not have either family practice or medicine/pediatrics residencies, showing that they don't have much of a general medicine/primary care focus. Also, if you look at their match list, they don't match many people into primary care fields. Some years not one student has gone into family practice. They do have some going in to internal med and pediatrics, but most of those want to subspecialize. I attended the school so I know what I am talking about. It is an academically rigorous school, but the focus is on basic science/bench research. The medical center is also well known for radiology, ophthalmology, pathology and cardiology, among other specialty areas.
You can definitely do primary care coming from Washington U., but some folks will actively try to discourage you from doing so. Also the teaching emphasis is on how to make you a good physician-scientist type, and a leader in some specialty field, so not a lot of emphasis on teaching the physical exam and other basics that would help you a lot in primary care. Also, there aren't many role models on the faculty for someone who wants to do primary care.
These US News Top 10 lists, etc. have to be taken with a large dose of salt, particularly the primary care rankings. Most of the state schools have larger primary care focus vs. the private med schools. That is just a generalization. If you want to do primary care, you can do it coming from any medical school. If you are pretty strongly interested in primary care, I suggest picking one you get a good "vibe" from when you interview, and that hopefully has one of the lower tuitions (without being totally run down in terms of hospital facilities, classrooms, etc.). You can certainly look at these so-called "rankings" but realize they are based on a bunch of statistics that really don't have anything to do with the teaching or things that affect you a lot as a med student.
