I go to a very small liberal arts college (330 people) and I love it there, but there are definitely reasons to do pre-med elsewhere. For instance, there is no specific pre-med advisor or committee, and when I talked to the bio and biochem professors about medicine, I learned that only one student every couple (~5) years goes to med school. So if you want to find clinical experiences and volunteer opportunities, you're kind of on your own. I'm a little lonely being the only pre-med around and I end up scouring sdn and wishing a little I had someone local to help me out with the process.
On the other hand, the education is first-rate. 3 of my classes last semester were just me one-on-one with the professor and it was fabulous. The type of research done at my college can be good or bad, depending on how you look at it. Students all do a 2-year research (or theatre, or whatever) project under the guidance of 1 or 2 professors. We design all our own projects and carry them out. This is a great learning exprerience (I love what I am doing). However, it doesn't allow us to get published with a professor already doing his or her own research, (The school is extremely student-centered and when professors want time off to write books or do their own things they just take sabbatticals) or to work in a "real" lab with PhD students and such.
So...it depends. You can defnitely make "pre-med" work out at a small school, and most are probably bigger than mine. But if you want a certain "pre-med experience" it might be better to go to a place that already had a program or something set up for pre-meds to begin with.
Anyway, I decided I wanted to "experience" the liberal arts more than I wanted to try to put together pre-med stuff at my college, and I've decided to do a 1-year post-bacc when I'm finished with my BA next year. It's because, while I'm confident that my actual pre-med coursework would be excellent, I'm not confident that I would be getting the research/hospital experience med schools are looking for, at least not easily.
PM me if you have any other questions about being at a small school. 🙂
Good luck!