I can really only speak for Rochester and Buffalo, but know the places quite well. Both cities have somewhat of a midwestern feel. There's a bit slower pace than the NE, the people are friendlier, homes are affordable, etc. Rochester is a bit more educated as a town (generalizing a bit) -- more educated, better schools, nicer suburbs. Buffalo is a bit more blue-collar, but still has some very nice areas around. Buffalo's a much bigger city than Rochester (about 500,000), but neither city has the feel of a big city at all. The night life is very limited in both places. But, if you have a family/significant other, either would be a very tolerable place to live for 5/6 years. If you're coming from a big city or from the NE, you'll be taken aback by how friendly everyone is there, especially in Rochester.
For a single guy, beware. There are very few single residents in either program for a good reason -- not much of a singles scene in either place.
All in all, I truly loved my interview at Rochester. Great program, really friendly people, amazing facilities, amazing faculty, amazing reputation, and a beautiful hospital that makes money and puts a lot back into the Ortho dept. Buffalo I was a little less impressed with, but it still has a very good and well-balanced program. Like the city, it's a bit more blue collar.
