I have a similar dilemma. In essence I am choosing between my state school and Georgetown. My state school is not "highly ranked" (in US News etc) but is located in one of the busiest medical industries in the country (as far as patient volume goes). There is not a deep hierarchy so 3rd and 4th year students get their hands on a lot of diverse cases quite often and in general simply get to do a lot in the hospital. On the other hand, Georgetown Univ. Hospital does not seem all that busy (opinions on this are also welcome) and this leads me to feel that clinical rotations are decent/good compared to outstanding at my state school. However, Georgetown med is a bigger and more prestigious name which may allow for more research opportunities and may open more doors for competitive residencies (such as surgical branches in which i am interested). As far locations go I know I will be happy in both locations for different reasons. D.C. is a better location as far as social activity and diversity go, but at my state school I will close to family. So both schools are even in that criteria. Assuming that money is NOT a factor which would you choose? A school with exceptional clinical exposure or one that is may not provide such outstanding clinical experiences but a more prestigious name and degree?