While I agree with Foxy that you must also try to evaluate the program by reputation, I disagree that county hospital makes a bad experience. In fact, I think a county hospital/VA makes a program stronger, because those are places where residents tend to get a lot of autonomy.
I went to med school in the south, at a program with both a county hospital and VA. I'm now an intern at a program much farther north, but also a place that has no resident autonomy. I can tell you that the skills of the residents at every level (including the about to graduate chiefs) are far, far behind the skills of the residents where I went to school. The residents there run the show. Here, you just do what the attending tells you to do. Plus, things are more subdivided here. (eg I know in several southern programs the trauma surgeons do most of the vascular repairs on vascular injuires. They also don't hesitate to operate on chest injuries. Up north, you have to call the vascular surgeon or CT surgery for those things, even if there is nobody on in house call for those specialites)
I think southern programs tend to allow more autonomy than the rest of the country.
Bottom line: I wish I had stayed in the south!
