Kind of a similar situation with me (though, again, not as extreme). I went to undergrad in Nebraska and he stayed in Colorado. We'll I didn't get into professional school my senior year so I moved back home. I got a job after taking about 3 weeks off of everything. My man didn't get a job for a year (nothing, not even Mickey D's). I reapplied, got waitlisted again. I was then offered a job at my undergrad to be residence hall director and I took it (salary of 26,500, don't have to pay rent or utilities, get the largest campus meal plan, amazing insurance, etc.). Offered bf to move with me (he finally got a job 2 months before I left), but he said no. Got here in August and finally, in October or November, he said to me over Skype that I care more about the money and job than our relationship because I was thinking I would stay in Nebraska if not accepted again mainly because we still couldn't move in together if I moved back. I'd drop to 20,000 a year without the benefits, which doesn't make sense. He told me that I wasn't thinking about "us", just "me". He never said that I was selfish, but I knew between the lines he thought I was. He finally told me he hoped I wouldn't get an interview (and by extension accepted to school) because it would make our plans harder to deal with. That's when I ended it.
When you're considering your own dreams and those of others, you have to be willing to compromise. I do believe that. If I was accepted, we were going to live halfway between my school and his job. I was totally willing to give up the ECs and stuff that come with vet school in order for us to both do what we want. However, the fact he wanted me to fail at my dream was unacceptable and at that point (to me), his needs took a backseat to mine. That meant that we had to break up as he was unwilling to continue in a long distance relationship.
You guys don't have the same goals. Your goal is med school. His goal is family. Though those two goals don't have to be mutually exclusive at all, it sounds like it is for you two as you guys don't have the same plans on how to meet both those goals. No matter what he says to you, I feel that you should break up. You just need to say your piece and be done. He isn't entitled to give you his opinion if you don't want it. You can literally call him, say, "I'm breaking up with you," and hang up. I wouldn't do it that way, but you're a different person than me as well.
