Peter actually makes this exact point in the project's README. See this section here:

https://github.com/peterldowns/pgtestdb#how-do-i-make-it-go-...

I'd just say that a nice thing about it on disk (even if you disable fsync) is that in case of a failing test, you can examine the post-run state which is occasionally extremely valuable.

Just turning off fsync is basically just as fast as a ramdisk and you can't use up all your memory with one big test.