Great point. That sdn member I mentioned also talks about this. He also had to pick between Buffalo and Penn, and chose the latter. Coming out of Penn, he felt that his classmates were more driven to specialize because they were surrounded by peers who wanted to do the same. Again, one can argue that this is totally dependent on the individual student, but I'm not going to discount the effects from environment and peers either.
As far as the cost goes, this totally depends on the op's plans. If s/he wants to specialize, I would think of attending Penn as an investment.
I do agree that environment has a big impact.
This is how I look at this:
1) Option 1: you go to buffalo, save 350k, and end up specializing= best case scenario
2) Option 2: go to buffalo, save 350K, dont get into your specialty, go to a GPR for 1 year to improve your app and reapply. You forgo about 60k in potential income as a GP (avg of lets say 120k starting salary)= still saved 290k.(wasted 1 more year than if went to penn then went straight into specialty).
3) Option 3: Go to buffalo, save 350k, dont get into specialty even after GPR, end up being a GP , ball out with little to no debt.
4) Option 4: go to buffalo, save 350k, end up not being interested in a specialty, and are super happy you didnt go to penn for that reason.
5) go to Penn: pay 350K, get into any specialty, depending on the specialty end up possibly paying tuition at that specialty and graduate as a specialist with over 450-500K of debt.
6) Penn, " " dont get into specialty, do GPR( forgo 60k), now you have lost out on 410K ( 350k Debt and 60K forgone income).
7) Penn " ", dont get into specialty even after GPR: you are out 410K in debt and are a GP and will forever regret not going to Buffalo...forever.
8) Penn , " "end up not being interested in a specialty, end up being a GP and prob not have as much clinical experience as much as you would have had going to buffalo.
The main point is: the best case scenario is the first option of going to buffalo and saving 350K and getting what you want, the worst case scenario is going to penn and either not getting into a specialty or not wanting to specialize anymore. I tend to try to avoid any possible option of having worst case scenario. worst case scenario at buffalo is still pretty solid.