As a current IM resident at WashU I can assure you that I have received top notch training. That is not to say that you will not receive equally excellent training at other top institutions, but I am certainly glad I chose to do my residency here.
Barnes-Jewish Hosptial is HUGE! While there are a number of private patients, there is an even larger number of patients admitted to the ward service everyday. Private attendings are, for the most part, easily accessible. On average, I would say that interns generally have equal numbers of private and ward patients at any given time. I think it is a nice system.
As for fellowship placement, WashU residents tend to do very well. I'm not quite sure what it means to "match locally" but if you mean that a number of residents every year decide to stay at WashU for fellowship, then you would be correct. The nice thing about this IM program, though, is that it attracts people from all over the country. While there is a large number of midwesterners, there are also a number of residents from both coasts and a surprisingly large group from Texas. So, there is also a good number of residents each year that match outside of WashU at other very good programs. I believe they hand out a list of "Where Are They Now" when you interview.
If anyone has any specific questions about this program, just let me know!
medstud03