I went to a crummy state school for undergrad, and felt like I needed to move heaven and earth to get into a top medical school because of my undergrad school name. I remember thinking before I took the MCAT that if I got less than 38, I wouldn't even bother applying for admission. Even with an MCAT well above 99th percentile I got all of 3 admissions, after applying to 30 medical schools including some that were unranked. So I kind of know where OP is coming from. Then I went to a top medical school, and found that despite an unremarkable Step 1 and clerkship grades I was able to get interviews at most top programs, and I'm sure school name was a significant factor.
I will tell you that at 'name' programs people focus on other things besides standardized test scores or grades - that's where the fairness comes in. Look at it this way: If I did nothing but study the first two years in medical school, my Step 1 score would have been 10-20 points higher easily, but I worked with a good research mentor and had six papers the first two years instead. Most of my classmates did research or some other activity that people at lower ranked schools, despite maybe a good fund of medical knowledge, aren't and can't get involved in. I was able to work with one of the most well known specialists in my field, who wrote a glowing recommendation letter. I have the advantage of a very successful med school alumni network, which is something tangible that will help my career. And despite people saying an MD is an MD, I have had a few patients in residency that instantly trust me more because of my school name. So is it really unfair to take those factors into account (patient preferences, alumni and personal connections, research, etc) over a higher Step1 or Step2 score? I don't think it's unfair.
