With a NEET UG rank between 4-5 lakh, getting a seat in a top-tier private medical college in Uttar Pradesh might be challenging, but it's still possible to secure admission in some private colleges. The availability of seats in private medical colleges largely depends on factors like the specific cutoffs for the year, your category (general or reserved), and the number of applicants.

In Uttar Pradesh, some private medical colleges that might consider candidates with your rank include:

1. Subharti Medical College, Meerut
2. Rama Medical College, Kanpur
3. Hind Institute of Medical Sciences, Barabanki
4. FH Medical College, Agra
5. TS Misra Medical College, Lucknow

These colleges usually have higher tuition fees compared to government colleges. Additionally, some of them may offer management quota seats, which could be an option if you're willing to pay a higher fee.

It’s essential to participate in the UP NEET counseling process, as seats are allocated based on the rank and category. Keep an eye on the cutoff trends and be prepared to explore management quota seats if required. Consulting directly with the colleges or their admission offices can also provide more specific guidance tailored to your rank and circumstances