I have a relative starting medicine this year at Temple as a continuing student. Pretty tough program and one is expected to do well in undergraduate. She had admissions in Ivies during undergrad.
There is no such thing as tier 5 for major university combined programs, it is only in some people’s heads that they have reached this tier. It takes same achievements and effort to get into most combined programs that are run by established universities and it a lot of cases it is pure luck that one gets into one vs other.