I think the biggest downfall is that the cost of housing can be pretty ridiculous. I'm in the mood, if not quite in the market, to buy, and I'm giving serious thought to living in Fairmont and commuting to Mo'town.
Traffic is problemmatic. I've described downtown Morgantown as a traffic jam between two malls. Home football games are horrendous, but there are only six or so. Basketball isn't nearly such a problem, but can cause minor delays (you can avoid the Colliseum, but if you work in either hospital, you can't avoid the stadium. Try for a shift that starts or ends after the game starts.
WVU isn't nearly the party school it used to be. Student neighborhoods--including near the hospitals--can get a little wild, but the post football hijinks are (usually) a lot tamer. Don't see near as many bonfires in the streets, unless it's a big win.
Mon Gen seems like a nice enough hospital. I have a couple of friends who work there. They have the same complaints everyone does, but seem to like it, overall. Ruby is OK. The magnet thing seems like a joke, at times, but they do try for a 5:1 ratio, most of the time, and that's significantly better than 6:1 (which still happens, at times). Lots of departments, and enough turnover that you can probably move around if you find yourself somewhere you don't like.
Being close to Pittsburgh is a plus, in my book. Morgantown isn't devoid of culture, but it can seem like drinking is still the major social activity. Pgh offers pretty much all the attractions of a big city, but you don't have to live there. Mo'town traffic is a good preparation for the 'burgh. There's a lot to do outdoors within an hour's drive, including some nice parks locally. Schools are decent, and a wide variety of churches. Most of my admissions list Baptist, Methodist, or Pentecostal (we are in the Bible Belt) but there are several large Protestant congregations, Roman Catholic, Greek and Russian Orthodox. The university makes Mo'town a bit more cosmopolitan than a lot of the state. Back in the hollers, a black person might as well be from Mars. In Morgantown, a black person is nearly as likely to be African as African-American. We also have an Hispanic community--he coaches the football team. Well, his name's Hispanic...
Winter's aren't that bad. Summer's are hot and sticky, but the mountains are close. We had a terrible drought, one Wednesday. It lasted almost the whole afternoon.