I am not saying you aren't a doctor if you attend medical school in Iowa, but what is the likelihood of getting the residency you want? I cannot believe how competitive it is to get a good residency these days.
Or if you want a job in a top law firm
I believe it will depend a lot on how you define "good" or "top". If you define these as primarily about proximity to Manhattan then I am sure you are right. If you define "good" and "top" the way I do then it is something different. If our hypothetical Iowan's hope is to be enter state politics or become a senior partner at an Iowa firm they will probably get farther from the state flagship than they will with the prestigious East Coast degree.
The one place where students coming out of Ivies and top prestigious schools are going to be at an advantage is if they are aiming for careers in business that are based on connections. That's a pretty narrow slice of people though. If what your kid wants is to be an academic, go to med school or go to law school they can certainly do that coming out of a state university or non top 100 private. I agree with the poster who noted that students who are the "big fish" often are in a great situation at some these schools. They can get lots of faculty attention and access to lab resources far beyond what they might get at a bigger reputation school.
And, again, there is no reason to believe top students from state universities and small less known privates won't be able to get into good graduate programs.
