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What I would do: I would bug Pitt to get me stuff before April 15 so I could make a decision. If they don't, I'd go to Iowa, have the fiancee go to WashU and then bug WashU like crazy to get off the waitlist. They seem to love people who love them and there is pretty decent WL movement, so I think you'd have a great shot. And unlike at Michigan, they give some pretty significant need based aid, so it's not like you'd be locking yourself into extreme debt. Then again, maybe Michigan will still come through.
this is what I would do too. plus, Iowa is a pretty strong med school by every standard and you would be <5 hours away