I think this is personal too. Personally, I would be miserable in a rural area. I am th epitome of a "city boy" so I would rather be in Boston than some rural city/state in which the scenery alone would make me go crazy. This is why I only applied to large, metropolitan, urban cities. I am not saying Tufts is the only choice I'd be happy with, but if I was only accepted to Tufts and, for example, university of kentucky, tufts is the easy choice. It's fine that you don't think the $100,000 increase is worth it, I do. Either way, I'm gonna have to pay off my debt in the way I know I'm capable of. Being poor is something I've been very accustomed to, so to live like I'm poor for a couple more years to pay off loans isn't an issue for me at all. In the long-run, being happy in med school will ultimately help me learn more and be the best physician I can be, thus I will probably make more money. If I'm miserable, it will affect my studies and I probably would not end up becoming the best doctor I could be and will make less money.