CCLCM is very PBL-centered and I think that works well with me, but it seems to me that VCU is trying to become this way as well...their curriculum changed to incorporate small group learning. Both have a similar half day schedule with a lot of independent study time. I am not completely sure about what type of medicine I want to practice in the future but I am not opposed to research (which is why I applied). I would definitely want to come back to the DC area post med-school, could CCLCM limit that opportunity? Basically, I really like both programs, although they differ in their curriculums and CCLCM is research intensive while VCU pretty much has no research ingrained into their curriculum, i could see myself being happy with either program. I really like Richmond and know I would be happy living there, but not so sure about Cleveland. I guess the dilemma is staying close to home and living in a city I really like but being 100K+ in debt vs. a full tuition scholarship at a prestigious institution far from my family in a city I'm not so found of?
Agreeing with what others said, if you're on the fence about research maybe VCU is closer to being on equal footing (though research aside, even as far as clinical diversity you don't get much better than the Cleveland Clinic and the system they have at CCLCM, which includes a VA hospital, a county hospital, etc). Also, if you're just looking to move back to DC to practice and, at this point, don't have some desire to be in academic med/some other more competitive areas then the difference in "door-opening" opportunities CCLCM would probably offer over a place like VCU isn't really as huge a deal.
However, while "going with your gut" is a viable option, and surely "gut" preferences should be included in the calculus, I do think it's important to acknowledge differences to complement the gut feeling with some reasoning as well. Some of those thoughts:
Concerning location, I think you have to decide what you want. If you'll be happier in Richmond and that's your end goal (being happy, it is a rational one to have), then VCU would win out on that front. I will say I don't think you should pass up opportunities (and the Cleveland Clinic is a truly unique, world class institution that will bring with it unique opportunities) just because you're comfortable in a current place without full knowledge and acceptance that you're doing so. This is to say, I don't think the schools are equal in what they offer, I don't think trying to rationalize that point is the way to go, but rather if comfort with location from the start (because my guess is youd grow to be happy at either) is the top priority for you then I don't see any reason to artificially overvalue the clinical/research opportunities at CCLCM because SDN says they should be the most important factor in picking a school. On a related note, I believe moving outside one's comfort zone can bring with it tremendous growth - I do think getting out of a comfort zone (leaving Virginia, being in a new city) is another "opportunity," but med school will be challenging enough and if that isn't the type of "opportunity" you want at this stage of life I don't see any reason to put an artificially positive value on it. I do think, as I stated before, acknowledging those differences exist is important because I think it then let's you know what you really care about and let's you decide accordingly.
Concerning the price difference, this idea that you simply "lose a year of salary" in a 5 year program flawed, and I've tried to write why on SDN before but usually it takes too long and just ends up as a wall of text so I'll just keep it to: cost, no matter how you rationalize it, will be tens of thousands of dollars less at CCLCM and you will come out financially ahead. Always interesting to me how everybody complains about cost, you even see articles by med students in the New York Times and on well-known blogs, yet when people have the choice so many go with the more expensive option. Granted, in this case I think the reasons are more legitimate (aka it kills me when people pick Hopkins at 250k over full rides at a place like Duke for the "prestige" difference).
Unlike so many that think you're making the most important decision ever when picking a med school and that prestige is paramount, I think if you're looking at an MD school you usually can't go wrong. Here you've got legitimate reasons for both schools. CCLCM is cheaper, VCU is in the better location (for you), and the factors that would otherwise separate the two schools (the fact that CCLCM is more conducive to competitive academic med positions, has more name-brand recognition for other jobs in healthcare (admin/policy), is a better place for research, etc) don't seem to be huge factors for you personally, at least not huge relative to something like location. As such, as long as after you pick you don't sit and agonize over the counterfactual I'm sure you'll end up happy and a great doc at the end of the day.
To boil it down to a direct opinion: For me, CCLCM was 100% a no brainer (incredible clinical and research opportunities, small class size that gives lots of individualized attention, inspired every time I walk into a world-class hospital, lower cost, pass/fail all years including 3rd year, etc). For you, trying to be rational/remove emotions you may be feeling from the choice and based only on what you seem to value in your posts and knowledge of med school debt, etc, I'd be probably 50.5% CCLCM (based on cost, because I think we're underestimating what tens of thousands of dollars difference means) 49.5% VCU (based on location, because it seems you really do value this over some of the bonus opportunities CCLCM may offer).
And that concludes my wall of text haha…but really, good luck with the decision!