Don't know a thing about Pitt, but I have spent time at VM.
Biggest drawback, you are paid at the R5 level and no more. No moonlighting to increase your income. When it comes to the end of the day, you act as an attending, but are paid a resident salary. Of course there is nothing to say you can't moonlight elsewhere in town. This may have changed in the last 12 months, but I doubt it.
However, they have a truly awesome faculty and program. Very forward thinking in terms of technology and procedures. Buy in from the surgeons and the nurses which is equally important to having good faculty. You have the guys who wrote the textbooks on old-school stimulator and anatomical techniques like Dr. Batra with young guys who excel with U/S like Dr Auyong and Dr. Joseph. Then you have guys like Dr. Bernards who will sit there and blow holes in all of the academic dogma you have learned over the past 8 years. I doubt there is a better place to get ready for the orals with good reviews every day.
All in all VM would be an AWESOME place if you can put up with receiving a ACGME level salary without being in an ACGME fellowship.
- pod