I've been accepted to my state school located in a small town and a highly ranked out-of-state public school in a large city (UWSOM). Tuition at UW is over twice as much as my state school, but I'm certain I will be happier there. Though my state school is well-run, it just doesn't compare to the opportunities, culture, or reputation of UW. Do you think it's worth the substantial tuition increase to attend UW? Thanks.
To me personally, no. To you, well that is up to you.
Keep in mind that this is a 4-year, not life-long commitment. On the other hand, you don't want to be miserable for 4 years.
You want to keep your debt as low as practical, but you will surely be making enough to pay down your debt, if the opportunity is worth the reduced spendable future income.
You will obviously have a lot less time in medical school than in college, so the environment of medical school won't matter as much as college environment, but you do want to enjoy yourself during your free time.
Pick the school that you will be happier and able to perform better at. Don't get caught up in the "reputation" of a given school, though, since the school you attend matters little. Is double the debt worth the 2 seconds it takes someone to say "Oh, that's a good school." when you tell them what medical school you went to?
Bottom line is, you will be an MD either way, if you do well you will have your choice of specialties and residencies either way, you will have the same basic foundation of knowledge to build from in residency either way, and when you have been an attending for 10 years, how much, really, will the medical school you attended matter? All things to keep in mind.