Hey allisonbk, I am in your exact shoes right now, and have no idea what to do. I actually liked aecom A LOT more than Downstate, but I still dont know if the extra money is worth it... I am leaning toward aecom right now for the following reasons:
1. My best friend was in our shoes last year, chose Einstein (she absolutely hated Downstate when she visited), and is even more happy there right now than she first thought she would be. It has far exceeded her expectations.
2. While I'm also not a fan of the bronx, the actual immediate area surrounding AECOM seems better to me than the one surrounding Downstate.
3. A good friend of mine is now a fourth year med student at Downstate and applying to residencies, and while all his stats are really good, he did not even get an interview with his top choice program (Columbia), and he is suspecting the less prestigeous reputation of Downstate might be the cause (But he did originally decline his acceptances to NYU and MSSM to attend Downstate). He now says that you pay for getting that foot in the door, and Einstein will accomplish that better than Downstate.
And lastly, this is not as big of a deal, but to address an above poster's comment about Downstate students always defending their school and trashing others, I just broke up with my ex-bf, who is a third year at Downstate. And one of our BIGGEST problems was the fact that he just couldnt seem to be happy for me for getting accepted to AECOM for example, and other schools that have a better reputation than Downstate. He proceeded to trash all of them, saying that I should go to Downstate, and that it's one of the best schools out there and that everyone else just hasn't realized it yet. He had the biggest chip on his shoulder that I have ever seen.
So yeah, those are my thoughts. Please let me know which side you're leaning on and which you will ultimately choose, because I'm also really unsure.