A little background on me, so that everybody knows my biases....
I am originally from St. Louis. I went complete 5 years in Boston University's BA/MD program (3 years of undergrad, 2 years of medical school), i transferred to WashU to complete MS3 and MS4. I matched at WashU for residency. Currently, I am doing research at Univ. of Chicago SOM, and will be returning to WashU in July to finish my residency.
My main points are:
1. WashU does have a high average MCAT score. In fact, all scores on standardized tests are very high at WashU (the average USMLE part 1 score for my year at washu was a 235, not including mine 🙁 ). However, just because people do well on the MCAT, does not mean that they are all "gunners." I have met a large number of well rounded, non-traditional background students.
2. WashU does definitely does not have a cut throat environment. The school's environment certainly does not encourage this; the first year is pass / fail, and clinical team sizes are very small in years 3 and 4. For instance, there are only 1 - 2 students / team on surgery, 1 student per team on medicine, 2 students per team on ob/gyn, 3 students per team on peds. Versus, 6 students per team on surgery at BU (when my friends were there). Also, the hospital has tons of patients and does a lot of operations, so nobody goes around stealing patients or cases from anybody else.
3. St. Louis will never be a boston or chicago. However, the cost of living is reasonable and it is not the hayseed backwater that everybody thinks it is (to answer the questions, no, I do not wear overalls when working in the hospital, and I did not drive a tractor to work), and washu locked tuition at your first year level (no 5% increase / year)...don't know if they are still doing that.
4. In retrospect, i think that the most important factor to consider when choosing a medical school is how the students match, and i have to say that coming from washu can only help you.
Anyway, I do not mean to belittle anybody else's medical school, I just wanted to say that I don't think that the stereotypes of WashU and its students are fair.