I can't say much about the gen surg program, but I happen to know that Philly's cost of living really isn't THAT bad. Nowhere near NYC etc. You can buy or rent, and the pub trans is reasonable. Residents can live in nicer NJ suburbs and ride a train (24/7) that drops you off at the hospital in 10-18 minutes. Not bad IMO. I'm married and live in Philly too, so I wouldn't rule it out on that either. Just preference.