Deferring a year would be foolish unless you have a very serious reason to do so. Every year, the match gets more competitive, school gets more expensive, and the interest rates on the now adjustable-rate loans will likely grow ever higher. Plus you'll be throwing away just under a quarter million dollars to opportunity cost just by losing a year of practice. If you want to go to medical school, the sooner, the better. Waiting a year in hopes that you'll be accepted to a better school or get some fancier letters after your name will likely make very little of a difference in your happiness in the grand scheme of things, but will cost you very much in return.