Core 3rd year rotations were set up by lottery. Originally they had said it would be by grades, but they subsequently reneged on that one.(I got screwed) Electives are basically set up on your own, but you'll want to do your electives outside anyway at teaching hospitals.
My advice to you would be to DO AS MANY CORE ROTATIONS AT TEACHING HOSPITALS AS POSSIBLE. My only real bump in the road at residency interviews was the fact that my 3rd year medicine rotations were at a non-teaching hospital(thank you lottery!). While the rotation was good(primarily because the Dr was awesome) I still got questions about it, and I'm not sure if I answered it to their satisfaction.
Second piece of advice: Do lots of oral presentations in your 3rd year. In my case, I hadn't done ANY until my first outside elective(ICU!)at the end of 3rd year. Predictably, the first handful of presentations were like oral diarrhea. Fortunately,the rotation went well after and I still got a good grade. Teaching programs are going to expect you do be able to do this when you show up. If your attending doesn't make you do these at the non-teaching hospitals take the initiative and arrange to do them anyway, or even with someone else if he/she isn't so inclined.
Aside from that, it's good to train at a teaching institution early so you're not caught with your pants down when you go out for outside electives, especially at places where you might want to go for residency. Generally speaking, you will have a lot more responsibility and will be expected to be more independent. So get used to this early.
Good luck. If you are mindful of the 2 points above, I feel you will receive the equivalent of training at any other program.
