quick FYI - Yale is not shortening their program anymore. Differences between Yale and Vanderbilt clinical placements - if I remember correctly - is that you have to find your own with Vanderbilt. They have a list of sites but I believe it's the students responsibility to set up sites. That could be either good or bad, depending on how you feel about doing that leg work. Yale places you with clinical sites, so there is no extra leg work. I can't speak to Vanderbilt's midwifery program, but the 2nd year specialty students spend their last semester fully integrated into a clinical placement. No school (I'm pretty sure about this, not in this specialty), just clinical practice. I would not devalue the importance of having a summer off, or just even having extra time to pursue other interests. While you may think you'd like to go straight through now, being in nursing school is mentally taxing, and it's exhausting to be in school all the time. Having the summer off allows many students to pursue other opportunities to strengthen their resumes, through different fellowships or traveling aboard and working in different global health projects. Also, rankings should not be taken too seriously. I have friends that have gone to schools ranked higher and had terrible experiences, with some even dropping out of the program altogether and choosing to go to programs that aren't even ranked.