I can't tell you what to do here...but have you two considered doing the long-distance thing for a couple years? I mean, why does it have to be break up or move in together? Many people in my class have LDRs, some ended in the first year but many are still going strong, several that I know of plan to continue their LDR for all 4 years of med school and possibly beyond. You can talk on the phone, you have the internet, and you can travel to see each other especially during the first two years, when he will have several breaks including a whole summer off. If either of you isn't sure about moving in together right now I wouldn't do it--I had to deal with a break up a few months ago with a person I had been living with for several years, it's basically like a divorce in terms of having to split up all your posessions, accounts, pets, etc. Definitely not worth all the stress. You two obviously need to discuss your options a bit more, but I would talk over the possibility of staying together even if you're in different states if you really care about each other and don't want to break up but aren't ready to move in together yet either. Good luck!