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I wouldn't defer a year. Theres really only about a 150K difference over 4 years of med school between in state and out of state. So.. if you get a job that makes more than 150K a year, then its better to not loose that 1 year of a doctors salary.
MSU's tuition is ridiculous for OOS, borderline extortion, but oh well...
But $150k + interest over many years is a lot to pay off when you could significantly reduce your debt by waiting. You might not want to wait, but I just recommend thinking about it at least - an OOS student at MSUCHM will accumulate debt around $320k, BEFORE adding interest to it. Should a person decide (or end up for one reason or another) going into family medicine, or say, pediatric pulmonary medicine - they won't be pulling in $320k a year that is for sure - perhaps not even $150k, depending - so this debt will be crippling for some time....