They have some awesome and unique programs. Mainly I remember the space program and the free clinic. Very cool. The students however are WAY too laid back for me. All they could talk about was the bar scene and how they would run into a million of their closest and not so close friends each time they went out. I don't like seing my classmates in the local Wal-Mart. I'd feel too much like I was on an island. Ha. And personally I like having people around who push me to do better, not who would tell me about their crazy, drunken nights out, which might make me feel like a nerd for studying.
I met some very dedicated, but nice types there. Third and fourth years interact with the patient population that I would prefer (very Hispanic) and have the option to go to the border for work. I hate the fact that the school is in a suburb, and I wish San Antonio had some more urban renewal going on. The traffic there is also horrific, which you might only expect in Dallas or Houston.
I think both have pretty equal reputations. Maybe not research-wise, but in my mind UTSA is not a research school. It came off to me as more of a clinician's school. UTMB came off as not a clinician's or research-based school, but a school that garners its reputation from its tradition as the state's 1st med school. Kind of like the Ivy Leagues have a "better rep" than Wash U and Northwestern even though some Ivy Leagues have fewer research dollars or push to do research. But they have a better reputation because they attract former graduates as faculty and are knowledge powerhouses.