Missoula was my second WWAMI month and quite different from the first.  Missoula is a university town and significantly bigger than Livingston.   There are multiple hospitals, plenty of subspecialists, and even some UW students running around;  it has less of the “small town doctor” feel.  That said it’s quite different from Seattle, and the exceedingly well-connected Dr. Schlesinger is eager to customize the rotation – I did two weeks of sports medicine and two weeks at a Community Health Center.  But one gets the sense Dr. S could arrange anything from the ICU to podiatry, probably with someone not used to having a resident and excited to do some teaching.   Go to Missoula to get away, see a different place, do some hiking/skiing, and all of that, but also take advantage of the opportunity to learn whatever you want.