I had a really hard time deciding between the Brigham and Hopkins. They are both great places to train - high quality residents, strong faculty, good atmosphere overall. I made a list of the two comparing them before I my rank list to help decide, but it didn't help much. Here's what I remember about Hopkins.
1) Andy's point about the structuring of the training is important - mixing AP/CP is good if yor going into practice but maybe not good if you're going into academia. 2) Hopkins does their signout in one giant room. I thought this would be really crazy and loud, but it wasn't - there was a lot of interaction among the different groups. 3) They have a beautiful new grossing room in the cancer hospital for grossing - very spacious. 4) Hopkins has scheduled didactics several times a week, at 7:30 AM - good if you like didactics, bad if you dislike mornings. 5) Hopkins residents spend time at an offsite hospital - again, good if you want an experience as a general pathologist, bad if you are really interested in academia. Overall, it didn't seem that as many people from Hopkins went into academia as the Brigham. I'm not sure it this is actually true or not.
One really nice thing about Hopkins is that Baltimore is much more affordable than Boston. For me, the programs were both so strong, it came down to other factors - where my wife wanted to live and what my gut told me. After my interview at the Brigham, I just knew it was where I wanted to go. It just felt right. I made second visits to both programs, though, just to make sure.
So, in summary, Hopkins was my number 2 spot, but I would have been very happy to go there. The difference between my number 1 and 2 was slight.