Since I'm only a first, year I don't want to get in over my head with my remarks, since I continue to learn more and more about this place each day!
As for Raleigh/Durham, yes it was (and still is) a tough adjustment. I miss the city, I think this area can get very boring, I don't like that I live in a cookie cutter suburban apartment complex, and I especially don't like that I have to drive everywhere. On the other hand, I love the weather here, and after getting beaten down by Boston winters for 6 years, this is such a huge relief. I like that there are quiet places to get away and go hiking, just a few minutes drive away. I really notice, every single day, how much friendlier people are here. I miss the Red Sox desperately, but the Durham Bulls are a nice consolation.
When I wrote about not paying for the 2nd degree, I meant that if you go for the MD/MPH, you only pay for 4 years of school (assuming you declare NC residency) rather than taking a year off and paying for an extra year to do the MPH. I believe with the other joint degree programs, you end up paying for 3 years of medical school and the full cost of the 2nd degree, or something like that. Either way, you're saving a year's worth of time and tuition that you would have spent if you took off an extra year to get an extra degree. Does that make sense?
As for the snobbishness, it's possible that my snob-o-meter isn't very sensitive after living in Boston (which considers itself the "Hub" of the universe
and going to Harvard. But overall, I think my classmates are not very snobbish at all. In fact, I think if you ran into people who came off as snobs, it may have been that they were just trying to impress you.
Just another note: I am definitely NOT a cheerleader for Duke. I am acutely aware of its weaknesses as well as its strengths. And the people you meet at lunches and in the interview holding pen actually are a pretty good cross section of students. They give us free lunch to go to lunches, and free drinks if we stop in the admissions office to chat . . . even those of us who are very critical of the place enjoy free food!