You don't do the math of very many ideas, then. He's looking at credentials that could comfortably put him into a six-figure job, and not slightly. Moreover, has he said that he's spending $300k on an MD? News to me he did. Lots of people get their MD for well less than $300k. You do know that, right? Are you psychic? Because I'm amazed you were able to conclusively determine that he's not going to a (relatively) reasonably priced state school without any indication whatsoever. In any case, even with your ridiculous numbers, I can tell you obviously don't hear bad ideas very often, if "essentially the worst" is one under which he could be making well into six figures and be debt free within 10-15 years.