Hi Daisy-
I know your question was hypothetical, but I think I noticed in other posts that you had had interviews at Downstate and Buffalo. From your location, you're from the Bronx, so may I assume you didn't want to relocate across the state?
Like others said, ADCOMS may frown upon your turning down an acceptance and question your sincerity about being a doctor if that was your only acceptance. I think if you reapply, they ask about acceptances and why you didn't attend or why you are reapplying.
But, I also know how it is to attend an interview and absolutely hate the school. That being the case, had the school I disliked been my only acceptance, I would have attended despite the location, the atmosphere, and the cost and tried to transfer my second year. It's hard and it stinks, but if my happiness were on the line, I would attend the school as not to rub anyone the wrong way and the try to transfer.
Good luck with your decision and I hope you don't mind my asking about your hypothetical.