<p>You are overthinking this decision. I will set UCSD aside, since that institution is so dissimilar from the other 3, and state plainly that if you are unable to obtain admission to medical school, it will have virtually nothing to do with Middlebury, Macalester, or Grinnell and everything to do with the student and person you are. Instead of trying to parse the fine differences between science offerings, local medical facilities, etc in the 3 locations, decide where you would be happiest for 4 years. In the end, living in the place and community where you are most comfortable will have a greater impact on your future success than some of the distinctions (rank, “opportunities”) mentioned in this thread.</p>