I'm an older MD/PhD applicant, and a former classmate of mine is on the faculty there. He absolutely loves it, and thinks the residency training is very high quality. I heard that UTSW went through some instability when their former chairman, Dr. Rosenfeld, stepped down about 7 or so years ago (he's now emeritus). I haven't heard what happened to the quality of the residency program during that time but imagine they would have had trouble recruiting residents. The current chair, Steve Cannon, comes from MGH and has been there since 2000. He has done (and I'm sure will continue to do) great things with the department. When I mentioned that I had interviewed at UTSW (loved it!), one of the Partners PDs said he thought Dr. Cannon was doing a great job and it was an up-and-coming dept. If they aren't getting all the best applicants yet (and I'm not sure they aren't-- my interview group was great), I can only imagine it's because their national repuation hasn't caught up to their actual quality.