The only knowledge I have of Vandy is this:
Yes, their new hospital is supposed to be amazing. When I was interviewing, I was told to come with a pair of workboots (??) to tour the new hospital (it wasn't quite finished yet.) I ended up canceling the interview because I ran out of steam at the end and really didn't want to live in Nashville (what can I say, I hate country music!) The office staff was very kind and courteous to me during the whole interview scheduling process (yeah, I know that's pretty typical, but there WERE places that weren't so friendly.) One thing, though - unless the hospital is complete crap or in the ghetto, all the bells and whistles don't help you much as a resident. It makes things nice, but ultimately the experience is still pretty typical across the board.
I know 1 resident in my current program who was from Vandy med - and didn't stay there only because of family reasons. I know one med school classmate who stayed at Vandy because her husband is there, and she couldn't say enough good things about it.
Another med school classmate loved it and ranked it first and didn't match there. However, that classmate ended up at a place closer to home that is much "higher ranked." Not sure how that happened considering Vandy isn't even ranked.
I think it's definitely a well-kept secret. I can't say anything about the snobbery, but if the rumors are true, that's NOT what I would want in a residency program. I am currently in a very supportive program, and the difference is amazing! I wouldn't have it any other way. I can't imagine Vandy being any different than Boston Children's/Harvard, CHOP/UPenn, Hopkins, Duke, Northwestern . . .
Good luck.