I'm going to plug Vandy- their med students are SOOO happy, and that counts for a lot. Step 1 is fine since their year 2 isn't intense at all. You don't get grades, so when the IM resident lets you go at noon..... you can go study. No penalty whatsoever for skipping out.
As you noted, though, they're going to suck at primary care. And honestly, assuming you take out loans, you'd want to avoid going into FM/general IM/peds with that kind of debt anyway (but that might apply to all three of these schools, I'm not sure). How much would each school cost you in total?
Yes, there are racist people in the south. However, the vast majority of people down here are completely fine/normal/not racist hicks, especially in urban areas. Like no way your classmates/faculty/staff will be racist, but some of your lower SES patients might be.
I'd avoid Case only because of useless mandatory things. But if you're the type of person who got into any of these schools, you'll match well regardless of where you go.