I graduated from a top program. Nobody cares. When getting hired as faculty, it's all about who you know and where you went to residency/fellowship. Getting a top residency/fellowship is more about clinical metrics (AOA, step score, letters/connections) than where you did your MD/PhD. Don't believe me? We had 4 students not match at all in one year at my MD/PhD program!
I also did very specialty-applicable translational PhD research. There are just no opportunities out there for me regardless. I think Osler had the better approach. Doing an MD then tailored research at a big name residency seems to be the right way to go these days. That helps you get the connections and do the politicking you need to get a position. That is far more important than actual ability. Research novelty in my experience is similarly frowned upon. If you get things going in an established lab and established area, you are much more of a sure bet.
Another good reason to go the MD only approach these days is: the research fellowship/instructor time is almost mandatory in a lot of specialties. The MDs spend more time there than MD/PhDs, but in the long-run they spend less time. An MD/PhD program is on average a 4 year PhD. I haven't seen an MD spend more than 4 years in post-graduate research limbo land. They either do special PhD programs that give 3-4 year PhDs or something equivalent, and then get the job. Meanwhile you have PhDs who spend 4,5,6 years or more on PhD being told they need to spend at least a year in a research-oriented fellowship position. It's less efficient. Sure, there is a money issue there where the PhD at least has no debt. However, the MDs can moonlight. One guy I know was making more money moonlighting earning his PhD as a resident than some junior FP attendings I know!
Here's a great anecdote for you. My dream job came up recently. I had spoken to that institution previously about the job, and they buttered me up for it. Told me lots of nice things about how I was perfect for the job and they didn't know anyone else with my qualifications. Great. So when the time came to hire, they hired a current resident there who has never had more than a year out for research. What qualifications did they have? They know that guy, they like that guy, and they're going to send him away for a *year* to get more training before he starts the physician-scientist position. Plenty of people out there I know like that. "Oh you have your PhD in this area?? That's nice, we have someone who did their *bachelor's* in a related area, he did residency here with clinical research in that area, so that's the guy here who does your area of research. So you see, no position is available for your research." That's been the line at a number of places for me.
Getting a PhD that you have no idea if you can use just seems like a dumber and dumber idea to me in the real world.