Not sure about competitiveness, but I was just talking to a friend who did the program a few years ago, and she said it was just as easy to set up global health practica without being in the global health emphasis (she did two global health practica and did not do the emphasis). So even if you don't get in to the collaborative or didn't end up applying, you can still choose to focus on global health on your own. Not sure what other benefits there are to actually being in the collaborative program. My friend also mentioned that people she knew who did the emphasis did not ultimately find it that valuable, FWIW, but this was a few years ago and it seems like they're making some changes with the switch from emphasis to collaborative, so who knows.