There is a 5-year contract for OOS students; your residency program can count toward the 5 years if it's an AOA program in Ohio. Or, there is an OOS Scholars program that waives the 5 year commitment, if you are selected for it. Or, you can even "buy out" of it after you graduate, but the cost varies by year. And yes, you get IS tuition after the first year, which saves $13k each year.