I think it's hard for a lot of us to get over the pure "prestige" factor when making these lists...I know I had some trouble with it as well, but at a certain point we are really splitting hairs...I was originally wondering about Pitt too as I loved the residents, PD, city etc, but feel it didn't get as much love from other PD's and the SDN community...then I thought about it, and realized I really liked the program and city, its an excellent medical center with specialties ranked in most fields pretty highly, and its fellowship match is really quite excellent....so is it maybe considered just a step below Vandy & WashU, sure! But I'm pretty sure not enough so to make any bit of difference in our future careers. Just pick the place you liked better and go with it!
For me, this means I am ranking Pitt > Michigan, Vandy, Cornell, Yale, and Emory on my list if that helps at all! Good luck though, I know how hard it is!