I interviewed at Downstate some time ago and didn't feel that great about the program. I was pretty open minded going into the interview and actually had high expectations for the program. What turned me off was my interviewer, who seemed more focused (and arrogant) on why he should choose me, rather than it being more mutual and why I should choose them as well.
The only perk about Downstate seems to be the fellowships. It has more spots than average for its more competitive sub-specialties like GI and cardiology. They prefer their own over others. To me, it seemed like the residents went straight into competitive fellowships without having to do a research or chief year.
The biggest negative I've heard is that there is unbelievable scutwork. I don't know the backstory to the nursing team, but I heard from numerous Downstate medical students that they were the ones drawing the blood every morning.... when it's the nursing's responsibility to do so. Or the phlebotomist. No resident that I asked gave me a straight answer as to whether the nursing is good or not. But I trust the medical students' perspectives.
That's my honest post. Hope that helps.