NYC is a strange place where there are quite a few 4 yr programs and I was interested in NYC but at the same time only wanted 3 yr programs. It was a tough call but I'm glad I made it.
Yes I'm biased, but allow me to say: don't go to a 4 year program.
why? because
3yr + 1yr fellowship >>>> 4yr residency
No one will dispute that. It will be hard to find a 4th yr EM resdient to look you straight in the eyes and tell you otherwise. No matter what you want to do, academic, community, I can't imagine a place in their right minds would hire a 4yr residency grad over a fellow, especially knowing that a 4 yr program usually means a more scutwork filled intern year.
Yes I know most of the 4yr programs are quite prestegious, NYC or not. They are 4yrs because they know they can and people will eat it up. Unlike surgery/radiology, name goes very short especially in our small EM world. No matter how prestegious the 4yr program is, don't let them tell you that they give you "more training" thus it's better. If that's true, all programs would be 5 years. You'll end up regreting it if you believe the name or "more training" will help you in the long run.
DO PICK the 4yr program, if you like the location or have family near by, which is much more important in my opinion, or if you truly truly believe that particuarly 4 yr residency is >>>> than 3yr + fellowship.