Not to mince words, but I disagree that the quality of your medical education and training as a medical student depends 100% on the student's efforts. I've heard this said a lot on SDN, and I felt the need to put this out-Sometimes you get a horrible rotation or the school has a really poor anatomy lab/microbiology lab...there are some things in medical school that you can't learn just out of the books.
I'm not saying the quality of education does not mostly depend on the student, I'm just saying that sometimes where you attend school will have an influence on how well you are trained and how well you do on the board examinations.
*I concur that most schools in the US provide adequate education, and that in the US, what you get out of medical school mostly does depend on student effort.