I also found using Visual 2013 on my surface that the editor is bound to the desktop but the .exe ran in metro mode, so I couldn't step through the program using F11 and see the screen update. Is there a way I could have a smaller window in desktop mode for debugging, then sometimes run the compiler and have it switch to full screen in Metro mode?
Not really, no -- If you just need to see the game screen and not really actively interact with it in a way that requires fullscreen while debugging, then you can make sure your game supports snap-view in a way that makes sense -- then you ought to be able to snap the Desktop and your app side-by-side. Another option is to debug with a second screen attached to your surface and run VS there (obviously its not always easy to have a second screen around). Getting possibly even less available, you can remote debug from another machine if you have one handy. A final option that requires a fair amount of investment is to have a separate build of your game for the desktop environment (takes a lot of effort, but payoff would be potential support for Windows 7, Vista, possibly XP, and opening yourself up to other marketplaces like Steam). My own current thinking is I have a set of builds targetting Win8, WinPhone, and potentially XBox One when they open up indie dev more broadly, and a different set of builds targetting the classic Windows Desktop (Win8 also, Win7, Vista, XP), OSX and Linux, all (Windows too) through OpenGL (A Windows Desktop App targetting DX could also be useful for debugging, and seems like a good thing for completeness, but I'm not sure its worth the effort yet).
If you're debugging graphics issues, another good option is to use the graphics diagnostics feature to record the problem from the Windows Store app, and then use the captured information to debug it from Visual Studio.