both are fantastic options! i have friends at both & have heard lots of great things about both, so you truly cannot go wrong! you will likely match into the program of your choice from either of these locations!
some other things to think about (in addition to the ones you've mentioned):
- I've heard that Duke is INCREDIBLE for surgical specialties & I know that UCSF med is very primary care oriented - not sure how tied you are to OBGYN but it could be something to think about
- a huge % of UCSF matches back at UCSF, given that UCSF residency programs love their med students & because genuinely a lot of the CA residents who go there want to stay in SF for residency; though I guess a lot of Duke MDs also match back at Duke... so I feel like this is the same regardless of school
- If you're super interested in an MPH and MBA (or even getting really cool research), I feel like the one year preclinical & third year being completely open is HUGE - but you can always take an extra year to get it at UCSF
- COL is wayyyy less in Durham; obviously, SF is a very cool city but you'll be able to live luxuriously in Durham if you were paying the same rent haha
- how do/did you feel about SF campus/safety/transportation wise compared to your experience at Duke? this is definitely quite different between Durham and SF & will also affect your experience, especially during clinical rotations
- regarding being in/out of your comfort zone, there's def pros & cons... med school will have its challenges, so I think there's merit in being near loved ones and familiar spaces (& being able to extend relationships you had with duke faculty members as an undergrad)! but also i'm anxious & risk averse so that's my deal hahaha
from your post, it sounds like you're more excited about Duke, but you have SUCH amazing options - excited for you! good luck!