I know a lady that was accepted to MSUCOM. When she asked someone in the admission office about the out-of-state tuition fee (about $38,000 a year), she was told that if did not want to pay such a high tuition, she could defer matriculation for one year. She could then work in Michigan and establish state residency to take advantage of the in-state tuition (about $17,000) when she start med school one year later.