I can't believe how often people on SDN don't blink an eye at cost when giving advice like this! I have spoken with a large number of practicing physicians and the consensus (as in, not a single one has disagreed) is that MD degrees are generally considered equal in the US. People care how good a doctor you are, not where you went to med school. And in this case, BOTH schools are prestigious. OP, even if you want an MPH from Emory, you could probably still do that with an MD from Iowa. You could take a leave of absence, or do it during residency, or even later down the road. I simply cannot see how people justify taking on 100k+ in additional debt +6-7% interest. That's a massive amount of cash, even for a doctor! (This probably speaks to why docs are sometimes criticized as being poor financial planners.)