I don't know anything about Albany, but I interviewed at UVM and was unbelievably impressed. But for the location, I thought it was an amazing medical school. The curriculum was excellent, the administration helpful, the facilities nice and new, the student body friendly and laid back, and the technology and online resources blew me away. If you don't need city life, I'd say UVM is a truly wonderful medical school, and that you couldn't go wrong there.
As for your question about "higher tier," I think that's pretty irrelevant. Unless you're talking about a top 10 or top 25 compared to a school that's not "highly" ranked, I don't think it makes much of a difference. Just go where you think you'll be happiest, where it's cheapest, and/or where you want to live. Good luck.