I guess I could offer a little bit of insight into the Detroit area programs, as I am a local Wayne State medical student pursuing EM.
Detroit Receiving: New ED. Rest of hospital a dump physically. Excellent faculty--some of the coolest people I have ever come across as far as personality, approachability, etc... Wicked cool trauma bay with three spots and overhead computerized XRay. Oftentimes trauma bay is full, blood is pouring, and procedures are underway. PLENTY of trauma. Codes are run by surgery and EM on ALTERNATE days. Trauma procedures are run by whoever is NOT running the code that day. Grads here are trauma and procedure PRO's. Legendary surgeons--makes for great off-service rotations. Nursing staff leaves something to be desired.
Sinai Grace: Never rotated, though alot of my classmates have. The most trauma in Detroit. West side Detroit in SHADY neighborhood, yet drivable and very nice living within 15 min drive. PD and assist PD are damn cool people. You probably cant get better trauma experience than this, and YOU are the people running the codes. Less academic than DRH, though you are very valuable on off-service rotations. Great drop-off crazy stuff. If you dig chaos with trauma, naked crack ****** running thru the ED, and plenty of good indigent pathology, this is a place to check out.
Henry Ford: Never rotated. STRONG reputation. Manny Rivers and his shock research is cutting edge stuff. Great off-service stuff. Good name recognition outside of Detroit. EM runs trauma codes...residents reported as almost "cowboy-like" with so much autonomy. Downtown Detroit. Nice facilities. One of my favorites in Deeetroit.
St. John: This place probably truly does get the best of both worlds in EM. Trauma with good procedures and bread and butter EM. Sits on the border of Detroit and Grosse Pointes ( a very wealthy neighborhood of Metro Detroit.) You can buy smaller homes in this neighborhood (or a section of it) for 160-200K and up. Very nice community. Residents here are treated well. FREE food for residents. Good Pay. Nice ED. Off-service stuff not as strong as above at least as far as reputation is concerned. Solid program. Name recognition might suffer, but I would seek treatment from any one of these grads.
Beaumont: Did not apply. Dont know much about it. Known downtown as Club Beau. A little more bread and butter stuff in a nice suburb of Detroit. Kinda "Cushy". One of my friends rotated and didnt care for it. Wont say any more cuz I dont know much about it.
Saginaw: Heard it is a small program, Good administration, know nothing else.
Detroit in general: Not as bad as everyone says it is...at least not in places that you would live. Contrary to what you might think, there are plenty of very nice suburbs within a 20 min drive that are affordable. Residents at all of the programs above are happy.
Why then, if all these places seem so great, am I leaving? One GOOD reason, my WIFE. She is looking for a bit more of a fancy-schmancy city. I actually like it here but am looking for some new scenery. If you are concerned that maybe you arent in the top tier of applicants but doesnt want to sacrifice great training, you need to at least check these programs out. Even if you are top tier competitive and want experience in the ED that they couldnt dream up for tv, check these places out. They are all comparable in training so if you cant visit all of em, use the above info and other resources to check out at least a few.