What kind of EC's set you apart for Top Tier Medical Schools?

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Do most academic physicians just prefer to do the academics as opposed to the clinical? Are my perspectives and goals weird lol
Everyone has their personal preference.
The institution makes money on clinical care and research. They lose it on teaching.
 
Is it possible to do more clinical than teaching in academic medicine?

I think we're talking about different meanings of teaching. If you mean classroom teaching, it certainly is possible. Because most doctors in academic medicine don't actually spend most of their time in the classroom teaching medical students. They spend their time on the wards teaching residents, interns, and medical students "on the job." It's how academic medicine works. The interns do the work, the residents supervise them, and the attending supervises everyone and teaches them how to practice medicine. Every now and then they might give a lecture.

Sounds like something in that realm is my direction. As far as work goes, I would like more clinical than not, however as far as paycheck goes - as long as I can work 40-50 hours a week, treat patients and teach so MED students/residents, have a nice house, afford all my bills, pay for my daughter’s college, eat out a few times a week, and go on 3 or 4 vacations a year I don’t care about a higher-than-needed salary!

I think working 40-50 hours a week is probably going to be too low unless you're in a super cushy specialty or have a super good arrangement (probably at a pay cut). On average, doctors work 60 hours a week. If you're in surgery, that's going to be more and if you're in a so-called lifestyle specialty, that'll be less.
 
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