I think a balanced opinion is needed (and I am a long time reader but I only posted 1 time before).
Go look at the current residents:
http://www.urmc.rochester.edu/smd/gme/prospective/neurology/our_residents/current_residents.cfm
There is NOT ONE from a very prestigious medical school, and this program seems IMG friendly as well, which cannot be said of any "top 10" neuro program. The quality and background of the residents says a lot of the reputation and desirability of the program. There are also 0 MD PhDs in the PGY 2/3 group, and given there are a lot more MD PhDs in neuro vs other specialties, a program's ability to attract these types speaks to the quality of the research angle as well.
Yes it is a big expanding porgram, lots of faculty. I would say if forced to rank the quality of the programs, it would be ranked in the 20-30 range --- very good, but nothing special.
At the end of the day you have to go where you like as well. I cannot speak to whether the residents are happier here or UCSF UCLA Columbia Hopkins and other top 10 programs. So if you like Rochester, don't hesitate to rank it high due to some worry that it is a bottom tier -- it isn't.