I'm a 3rd year at Stony Brook. The only thing I've done at NUMC this year is psych. We saw some interesting cases, but there was way too much paperwork, and very little patient interaction outside of interviews with the entire team (i.e., attending, resident, social worker, medical students, miscellaneous). From what I've heard about others, they are pretty self-directed. You can be very involved, or you can round for a couple hours and disappear to the library, and no one will notice. I think from a grading standpoint, you will likely do better (and work fewer hours) than other places, but the learning and overall experience will be sub-par. Hopefully the administration will be able to equalize it somewhat.