Yeah, I definitely know how agonizing these decisions can be. I was deciding between Tulane, Vermont, St. Louis, Finch, NY Med, MCV and UVA. I grew up just outside San Francisco, went to college in Durham and currently live in D.C. Although Charlottesville doesn't have any good clubs, it has all the other benefits of a big city (good bars, restaurants, etc.) while still being beautiful and safe. The reasons I chose UVA were its national reputation, its amazing match list, its dedication to primary care, its flexibility during fourth year (there is a required one month neurology rotation but the other 11 months are free for your choice of subinternships, rotations around the country or the world, etc.) I also liked that the Grounds are beautiful, the city is fun and pretty with lots of outdoorsy things available, and everything is within walking distance (7 gyms, classes, hospital, undergrad and other grad campuses, the Corner, etc.) The cost of living is pretty cheap in C'ville and the out of state tuition is such that I will save about $20K over the other schools I was considering. The students there are really awesome and fun, the professors really care about the students and are constantly making changes to improve the curriculum and make students' lives easier, the library is new, huge, and awesome. There's really good hiking, whitewater rafting and kayaking around and Richmond and D.C. are close by. I could go on and on!