This study is one of a larger inquiry into organizational stratification. About U.S. medical schools it asks: How does a sample of full-time clinical and basic science medical school faculty rank 94 medical schools as to quality of faculty and effectiveness of instruction? And: What are the structural correlates of such rankings? The resulting rank order takes on significance as it affects recruitment and placement of students and faculty. Measures of aggrandizement (inflated estimates of worth by insiders) are estimated. Characteristics of medical schools that correlate with perceived quality are: research and publication, eminence of faculty, training and research grants available, size of full-time faculty, and perceived effectiveness of training. While the data support the view that reputation stems from functionally appropriate performance, there is some evidence of a ceiling effect (Harvard) and a halo effect for schools affiliated with universities having national reputations. Regional location is positively associated with perceived reputation in the North and West, negatively in the South. Caveats are entered about interpreting the data.