Hey, current M4 at NYMC here (so biased opinion incoming, take w/ grain of salt).
Can't speak to Downstate at all as I never applied/interviewed there -- did interview for residency there, however, and I've read a couple thought pieces expressing concerns about finding enough spots for med students/residents to train with the closure of the hospital (something that is already a historical dogfight in the NYC area, especially since it's a prime Caribbean/IMG training ground on top of all the schools). Speaking from personal experience from my clinical years, it definitely makes a difference to your clinical learning when you are rubbing shoulders with too many other students. It reminds me of the closure of Hahnemann for Drexel -- whether it's defensible or not, I can very much understand people who were spooked away from going to that school after that. The associated teaching hospital is a huge part of your experience at a given school
NYMC is certainly a humble name and lives in the shadow of its ivory tower neighbors, but our match list this year was very solid and students year after year consistently match at big-name programs, so going here won't hold back the motivated student. We have people not only matching into competitive specialties, but into competitive specialties at competitive programs. WMC is an excellent place to rotate. It's technically a quaternary referral center and the only one between the city and Albany, so you see crazy-obscure cases/pathology and faculty are accustomed to having students, so it's good formalized education. I learned a ton on my rotations here.
Not sure how much the price differential is, but this is absolutely worth considering. It may feel like a drop in the bucket when all of them are six-figure debt figures, but as an M4 looking at my loan burden, thinking about still owing debt well after I'm graying at the temples is a bit of a punch in the gut. A matter of even a few tens of thousand translates to years more of payoff. This is unfortunately one of NYMC's biggest drawbacks, but thankfully our financial aid advisor, Tony Sozzo, is an absolute treasure, which helps. He's always on top of the latest headlines about debt forgiveness, etc., and works very closely with students to ensure we get the best possible payoff plans & game the system to its max. He really cares about the students and is there for us as an advisor long after graduation.