I mostly disagree with your first point. LECOM has never pushed primary care on us, and there are apparently people who will facilitate opportunities for students interested in certain specialties to network and build their resumes to match at prestigious programs. It's easy to complain about LECOM's obsessive attempts at maintaining a certain image, but it cuts both ways. They want us to match well.
I passed on schools that were slightly cheaper than CCOM for LECOM, and declined my AZCOM interview on account of the expense. It's just not worth it to pay an extra $100K (pre-interest, too) for the same degree.
I'd be interested in why you think their rotations are so superior. We send people to University Hospital in Cleveland (major MD academic center with something like 1000 beds and every subspecialty imaginable), St. Elizabeth's in Youngstown, OH (550 bed Level I trauma center), Conemaugh in Johnstown, PA (450 bed Level I trauma center) for our bigger hospitals, and we have a pretty wide spread of hospitals coming in at around 250 beds (some of which almost exclusively take LECOM students and have or are opening competitive residencies in the next 2 years [(Arnot Ogden in Elmira, NY, for example, will apparently soon get ENT, radiology, emergency medicine, and more in addition to programs that are already open]). Many of them aren't in major urban areas like Chicago, but you'll still get a good education, and the cost of living will be lower. Additionally, almost everyone now has a "core" hospital and doesn't have to run all over the state or country to do rotations, unless they prefer that. I can't speak to specifics of what CCOM is running, but I'm very excited about the opportunities I'll be getting in my clinical years, and I think they're only going to get better.
But yes, board scores are very important. And you know who's up at the top year after year, don't you? 😉
I wouldn't really concern myself with "reputation" for osteopathic schools. If you're applying into the allopathic world for residency, apparently even coming from the big name places like PCOM and CCOM, your interviewers will still be like, "Oh, that's one of those DO schools, right?" The residency programs that your school supports will usually favor you, though, so that's worth some consideration. Not a deal-breaker, but it's something.
EM is increasingly competitive. I don't forsee it getting to the level of surgical subspecialties or dermatology in our lifetimes, though. It's not a true "lifestyle" specialty, and the work is unique enough to turn a lot of people off. But that's a side issue.