If BU is the only place you are accepted then you are sort of trapped into accepting their offer, I would think with the economy students would be more concious about not choosing a medical school that will basically play a big role in dictating future decisions they make. I.e. for the amount of tuition you will pay, it is a significant factor I have seen for a lot of people in terms of where they can afford to live, can they afford to start a family or must they wait. Plus given that Boston is practically the most expenisve place to live, you get a double whammie. For the drop in quality of the education over the years, i.e. good attendings leaving and uncoordinated 1st and 2nd years, as probably mirrored in their drop in the rankings, they should lower tuition as students are just not getting the same product anymore, but they won't . . . a lot of people get in off the waitlist at BU as more competitive candidates go elsewhere, I doubt this year will be any different.