St. Louis is a metro area of about 1 million people. It is not like the coasts. That is a good and a bad thing. Good, you can afford to live a nice life in St. Louis on a residents salary, and there's a lot to like. Bad, it is not as diverse or cosmopolitan as NYC, SFO, etc. (Although the stereotype of it as a midwestern cow town is overblown)
No doubt, Wash U is a solid program from a research perspective.
When it comes to St. Louis, I think you'll find that the stereotype is less midwestern cowtown, and more trashed, dangerous, crime ridden, abandoned buildings, etc. This is only partially true.
I personally hate the city, having been there for 8 years and gone through college and med school at SLU, and having routinely lived in the bad areas. BUT, there is a strong effort from the city to revitalize previously bad areas, and it's looking pretty sweet in certain areas now.
For somebody considering spending 7 years there (for Wash U surgery), it's important to remember that it's ranked #1 most dangerous city in America, and
that does not include East St. Louis, which is it's own city, separated by a river, and probably the worst place to get lost in the entire US. But, it should also be considered that there are nice and relatively safe places to live, and there's a lot of fun things to do. Just do your research before signing any apartment contracts.......