I had a very similar choice when I graduated school (and I'm in Metro Detroit also): full time nights on a neuro floor at a large, prestigious teaching hospital, or full time nights in the emergency department at a community hospital within LTH's system. Also much like you, I had an old instructor championing me for one of the positions, and being in the same system, the pay was the same for both. In my case, drive time wasn't a factor, since both hospitals are more or less equidistant from my home. (LTH is 15 min by freeway or 25 min by surface streets; CH is 7 min freeway or 15 min surface streets, but that freeway is home to a large, old-growth stand of orange barrels
, so it's largely not worth the bother.) I had family connections at both hospitals (father at CH, mother at LTH). Emergency was what I wanted; neuro I knew I could do, but it wasn't my cup of tea. Both jobs came with a 15-month commitment, so if I hated it I'd be stuck for that long.
In the end, it all boiled down to prestige and culture. Large Teaching Hospital is a very
well-known and well-respected institution, one whose credit would get me in the door just about anywhere in Michigan. Community Hospital's quality of care is just as good, but it's much overshadowed by its parent organization. Likewise, people at LTH are justifiably proud of themselves, but rather prone to backbiting and belittling everyone who isn't them, while CH is a much smaller environment but offers a much more cohesive, supportive atmosphere.
I went to Emergency at CH. Best decision I ever made. I work with some absolutely amazing people, I've had the opportunity to develop leadership skills and help improve care standards that I never would have had at the big hospital, and I can honestly say that I love going to work every night. And - in a case of it all coming full circle - I now have people from LTH actively recruiting me to go work in Emergency there, as well as recruitment offers for the Level 1 trauma center at Huge University Health System (major boost in prestige and slightly better benefits, but less pay, a very restrictive union and a 1 hr+ commute, such that I'd more or less have to move). I don't think I'll ever leave CH entirely, though - quite honestly, I like the place too much to leave!
In the end, you have to do what you think is best for you. It may be to your advantage to start in emergency at the smaller hospital, get your skills honed and work your way to a larger institution. On the other hand, as others have said, you don't want to burn any goodwill you may have accrued at the larger hospital, and depending on where you are, the job market may be such that you'll have much more difficulty getting back in the door. I'd also tell you that in either instance, you can stick anything out for a year if you turn out not to like it. (What I don't think I'd place too much emphasis on, though, would be the driving distance. As you're no doubt aware, between snow and construction, any
commute can turn into a hour-long adventure...!)
Wherever you go, I wish you the very best of luck - and do let us know where you end up.