Pros
No doubt that Duke maintains a preeminent status among academic medical centers, and for a medical school that only started in the 1930's (compared to Harvard, Penn, or Hopkins) in a sleepy Southern town, it has overachieved. Department Chairman such as Eugene Stead in Medicine and David Sabiston in Surgery made Duke a clinical powerhouse; and Duke definitely rides on the foundation and reputation established by such figures.
Cons
Still, it would be hard to call Duke a "well-rounded" institution; in the biomedical sciences there aren't any Nobel Laureates, as such its Basic Sciences, while superior to most universities, is still a step behind the Harvard's of the world. It's hard to know if this is a trend across most research institutions, but Departmental Chairman seem to have a diminishing status at Duke.