JDH is spot on. I would say the big name programs are worse for the clinically oriented, private practice bound person. The "academic" progrsm (Colorado, Harvard, UW, Hopkins, Vandy, Pitt, etc) are funded by NIH T32 training grants that get refunded based on the % of fellows enterring full time academic medicine (i.e. research). Generally, you do 18mo of clinical then 30 months of academic time with an MPH, MScI, or Phd rolled in. These places generally discourage the private practice bound people from applying. They do clinical research but don't expect the same # of bronchs, perc trachs, ICU months, PFT reads, etc. etc. from the big name academic spots. There are other academic hospitals that have wonderful clinical fellowships that will train you to be an incredible clinical pulm/cc person.