would the decision be different if closeness was not a factor? i know uwsmph is higher ranked by a fair amount
Yeah great question. You should then consider things like location, weather, match lists, what kind of specialty you want etc. It gets really cold in Wisconsin. Also Wisconsin (Madison) is not really diverse in terms of patient population, which I think if that is important to you, you really need to consider that part. Milwaukee and Chicago are much more diverse if you want a point of reference. When my friend moved from Houston to Madison (they were URM), they felt like they just did not fit in, but to each their own of course. I feel like I would rather pay 10k more / year (if i had the choice) to tend to a population I care more about (my logic is im going to be in debt anyways and that much is not that much more in the long run).
I remember when visiting Boston / Tufts area was such a drastic change from Madison in terms of diversity and food options....and if that is something that would be off-putting to you I highly recommend leaning towards Tufts. You mentioned you would have to transition a lot into Wisconsin and I would agree. The state do be chilly sometimes, and it's not as metropolitan as Boston or Philly.
Wisconsin might be higher ranked because it is a "big 20" undergrad school. But again it's the ability to go to a place to help you be the best doctor you can be and get into the specialty you want (*which to some manifests into how the match list is*). Most UWSMPH students match in the Midwest and Wisconsin because they are known there (although most people who attend UW are from Wisconsin). If matching out of Wisconsin is important to you, I would pick Tufts. Also Tufts has a larger network of hospitals and clinics in which you can do rotations, and all of it is fairly accessible by train. In Wisconsin, you would have to have a car by M3 and be comfortable driving in ice and snow, especially if you get placed in a facility up north.
TLDR - if saving that 10k/year matters a lot to you more than tending to a diverse patient population and eventual ability to match to where you want to live, then I would say UWSMPH. But from the sounds of what you're looking for, Tufts is better aligned and you have a great support network.