In re. to Draper's observation comparing Vanderbilt's surgery with the "Big boy's" (Yale, Stanford, Duke, Hopkin's, Brigham & Women's):
Ironically, being compared to the residents @ several of those places is probably not the highest compliment you could make. While no one can argue about the quality of fellowships at several of those places, the general surgery programs can suffer a bit in comparison. This phenomena is very common especially @ institutions with outstanding vascular or thoracic fellowships where you end up being boxed out of many of the most interesting cases. The attractive factor at many of the general surgery programs with the biggest names often lays upon the success in postgraduate fellowship placement rather than on the general training as an end to itself. Those programs also almost uniformly require 1-2 years in the lab which can delay clincal practice to your mid to late 30's.
You'd be surprised at which university programs get real strong word of mouth for general surgery(it varies year to year) like UTenn-Memphis, Wake Forest, Univ. of Florida, UT-Southwestern, Louisville, Cinncinnati, or Michigan rather than the Harvard,Yale, MGH, or Duke crowd.