Ok so first off, Roanoke is a small city but it doesn't lack the conveniences of a larger one. There is a 24 hour CVS and grocery store for starters and you have your starbucks, chipotle, froyo etc...This is all within a 5 minute drive mind you. The restaurant scene here is surprisingly vibrant and there have been at least 3 new restaurants that have opened since I started school here. There is also a pretty large commercial district by the airport that has everything you can imagine (Lowes, really nice movie theater, Walmart, Ross, BBB, Dick's, strip malls, etc...)
I'm not sure what the weather was like when you came here to interview but the views you have here of the mountains are quite impressive and not something you'd get in an urban environment. That said, Roanoke is very much an "outdoorsy" type of place. People run, bike, hike, walk and enjoy taking advantage of the area around them. There is a paved trail called the Greenway here and it runs along the Ronaoke River which you'll find lots of ppl exercising on. There's mill mountain (which the star is atop of) and a quaint zoo located at the peak.
Now onto the cons, Roanoke is a small city so you're not going to have a similar club scene as you would in DC or NYC. In fact, I'm sure a lot of my classmates would agree that the places you can go to get your dance on are limited. That's not to say there aren't cool bars or places to chill at but that is a con. Additionally, traveling within Roanoke is nice but if you plan on going outside of the city, the next major one is Blacksburg, ~40 minutes away which shows how isolated we are.
To be honest though, I've been extremely happy living here and in my spare time I like to sleep in, get some casual reading done, ride my bike or spend time with my dogs. In addition, with only 42 classmates we're pretty close and end up hanging out a lot so I consistently play basketball, watch the walking dead, catch a movie, jam on Rock Band etc... with my classmates during our downtime/when we get tired of studying. There hasn't been a time where i've thought, "man, i wish Roanoke had.....X." Except for good Korean/Chinese food if thats a dealbreaker for you haha.
Unfortunately I can't really comment much about the clerkships and match being an M1 but i know that there are M3s on this forum who might have some free time (just maybe)
hope this was useful!