Letters to the Editor
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publications
I don't know about medical research, but in some scientific fields (including atmospheric science which is the field I work in), the authors (hence the federal government who is funding the work) actually pay for their article to be published in many of the leading journals. These articles still go through scholarly peer review - it is not a vanity press, but the page charges reduce the overall cost of publication of the journal. However, these types of journals are generally run by scientific organizations (such as the American Meteorological Society or the American Geophysical Union) rather than by publishing companies.
Historically, many scientific promotions (and hirings)have been tied to the number of publications. Needless to say that has led to what we might call publication inflation, and so some institutions are starting to look at number of citations and number of publications in "high-impact" journals to get a better idea of the quality of the publications. However, I would say that it is only a few institutions at this point which directly consider citations and impact factor in promotions or hiring decisions.