Personally I don't like NYC, so that kind of makes this easy for me. But really, cost of living is better out of NYC. Live a better life with a lower cost of living. If you see yourself in one location long-term, maybe go there so you are familiar with the laws and practicing medicine in the area. Otherwise, worry about natural disasters? If one has more fellowship programs it may be a good opportunity to explore those on your home campus. Just my thoughts, but i would go MUSC.