Merit grants & scholarships should always matter, regardless of parental income!
D27 has very high stats. Tuition keeps going up and up. Students have to plan ahead for possible graduate & professional school. No one can make any assumptions about what future household income could be.
That’s great! 
Let me know if you have any specific questions along the way.
Budget assuming 8 years of university. Many have suggested figuring $400,000 for medical school. However, if medical school happens it is multiple years in the future, and prices are going up over time. I might plan on $500,000 for the four years of medical school (perhaps starting something like 5 or 6 years from now). Where the stock market will be at the time is something that is beyond my ability to guess.
Most students who start university thinking “premed” end up doing something else. However your child has superb stats and ECs that at least to me make it look like medical school is entirely possible.
This is going to depend upon the student. Taking premed requirements such as organic chemistry and also taking engineering classes at the same time is going to be tough, but if anyone can excel at this it at least might be a student with straight A’s out of high school and a superb 1560 SAT (I hope that you are very proud of your child). I have seen students who said that organic chemistry was “the hardest B- in my life”, “the only C in my life”, and “no big deal, organic chemicals fit together in ways that are logical which makes it easier”. The latter reaction seems to be rare but apparently is possible for a few students. Similarly some premed students will think that the required physics and math classes are tough, while others may think that these are the solid A’s that make up for some B’s in other classes. It varies.
To me it seems perfectly okay for a very strong student to start off with premed intent plus an engineering major, and see how it goes. If it is too much the student can either stick with premed or stick with engineering and drop the other one. If a student excels in this combination – something that would probably only happen for a small number of very strong students – then they can go for it. With this combination as a freshman in university, I might want my child to know that if they do drop back to either “premed with an easier major” or “engineering without the premed classes” that is entirely okay and either way is compatible with a very good and successful future for them.
I guess if your child gets into Duke ED then the decision is made. Otherwise it would not surprise me if your child ends up with merit aid at Pitt, a very affordable in-state acceptance at UVA, and full cost acceptances to one or more schools from this reach list (and/or WUSTL). Definitely keep the cost of medical school in mind when deciding between these options. For us this would not be an easy choice to make. Pitt and UVA are very good schools.
There are a lot of types of engineering. There are a lot of applications of mechanical engineering. To me it seems very reasonable that some of this might benefit from having some medical experience also (someone has to design all those machines that we see when we go in for our advanced medical scans and treatments).
Now I am only guessing, but… Duke is in North Carolina. Salaries for the same job might be lower compared to MIT / Boston or Stanford / Bay Area, but a lot of this would be just because of the location. I can see why Duke might therefore intentionally not list salaries.
Others have wondered why MIT is not on the list. Given the intention of starting off with both premed classes and an engineering major, to me it makes sense to leave MIT off the list even though MIT is so strong for ME. On the one hand the premed/engineering combination is already tough enough without adding MIT (or Caltech) to the mix. Also, MIT has a lot of general education requirements and students typically take fewer tougher classes, so completing both engineering requirements and premed requirements seems like it would not be easy to fit in a four year schedule there. I think that I would leave it off the list also if this were me or my child.
Best wishes. It sounds like you have a great student!
Not a perfect data source by any means, but College Scorecard (the same data US News uses for their salary by major analysis) shows Duke placing quite well in mechanical engineering salaries at 4th highest overall - Search Fields of Study | College Scorecard - and all the engineering salaries there is data for, so not something I would be worried about in making this decision.
yes, it’s quite imperfect actually. I know in theory you can filter for major but it really doesn’t reflect the exact major median. If the school happens to offer that major, it will just show that school and the overall median across all majors but not specific to the major. At least that’s how it appears to me.