I had a talk with one of the interns on my job. She graduated from Upstate and matched in IM in a prestigious program. Since I am considering Upstate, I asked for her frank opinion on the education she recieved. She said her board scores were above average, and that most people in her class did very well on the boards. She felt that, in retrospect, clinically she may not have been exposed to many things. She only feels this way now because the other interns she works with seems to have performed more procedures as students than she had. For example, the first time she was about to do a LP as an intern, she realized the other interns on the team and even the med student already had many experiences with doing the procedure.
She felt there were several things at work. First, she is doing her internship at a health system who's med school is ranked in the top 5, and the students are very assertive and have super early clinical exposure. Also, the location offers opportunities for many procedures and a greater exposure to certain disease processes that you may not see as frequently at Upstate. She also blames some of it on herself (and not the Upstate program). For example, as a med student, she chose not to spend any time in the ICU because she didn't feel confident enough to deal with such sick patients (while other classmates did). That same fear caused her to rarely volunteer to do procedures as a med student, while others jumped at the opportunity. Now she feels she is paying a small price for that.
I think there is something to be said for taking some responsibility for your learning. Opportunities are always there to help you prepare to be great doctors, but you need to figure out some of your own needs, and be curious and assertive enough to seek out more clinical exposure. She did say aside from the snow, she had a good experience at Upstate, and that adminstration is supportive.