The whole idea of predetermined "tiers" is ridiculous. And it's based on the ridiculous notion that other people's opinions of a program are more important than your own with respect to location, diversity, opportunities as a resident, and opportunities for career advancement. There are several programs considered "top tier" by the SDN community that I would not consider applying to even if I had the marks.
I genuinely feel for people who choose to spend 3-6 years of their prime in boring places in pursuit of "prestige" especially when those people could have gone to great programs considered "mid" or even "low" tier in incredible locations.
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