First, congrats on starting clinicals soon! I'm also in Miami here with my family and we're certainly enjoying the area as much as we can.
As for being at a disadvantage compared to those in New York (or even New Jersey), the short answer is yes. The hospital I work with has only DO residencies, so there is no way for any of the IMG MD students to get a residency here. A small caveat, since the MD/DO merger is looming on the horizon, many of these residencies are going to have MD spots very soon (within two years or so).
Another disadvantage is that you won't be able to experience different hospitals (at least, that's how my school does it -- and given your post I'm assuming we go to the same "top big four"). In other placements for clerkships you can at least see how different hospitals operate, but not in Miami. Most of our rotations are done through one hospital and another very small off-site clinic (that then sends you out to various small private clinics). However, your fourth year rotations will allow you to explore different hospitals -- so it's not all doom and gloom. This is where you want to do most of your impressive work, so going ot New York and making connections would definitely help during fourth year. You will be limited to which hospitals you can rotate at because some institutions only accept those who have done core-rotations with them before, but that is true for all students who were not able to get a core at that particular site.
For me it was really important to stay in one location for 3rd year because I have a son who just started preschool, and moving around would have proven too difficult for him. If I were a single student, I probably would have not picked a spot at all and had the clinical administration just pick any random spot (more variety, but certainly more crazy).
If you decide that you would like to switch clinical locations it is possible (at least at my school), but the administration will not make it easy for you and claim it is not possible. The strategy I used was to find a person at the location I wanted to be at (Miami) and who mutually wanted to be at my assigned location. We then both sent letters to the clinical administration and asked for the other's location without mentioning that particular person by name (this was important because the school doesn't let you "switch with people"). We were told that we would be put on a wait list, and about two weeks later the switch went through.
Overall, I have enjoyed Miami because it's not as crazy as some of the other hospitals in New York; a plus for me but a minus for someone who's interested in surgery, ER, or anything trauma related (we see zero trauma at my hospital). However, the hospital has a fantastic psych program, which is what I plan to apply for in residency. The hospital does have a ACGME accredited psych program that IMGs can apply for and have been accepted into in the past. We also see a lot of geriatric patients and have a contract with the Department of Corrections so we get to see prisoners as well (which has turned out to be pretty interested for anyone who is interested in psych).
So the real question is what do you want to do? Miami can be a great location for some and a miserable location for others.
I hope that helps some and good luck!
P.S. It also helps if you speak Spanish!
