Also, the $220k+ that you will save by taking the full ride at NCSU can be used to pay for medical school costs. If you attend a lower cost medical school like ECU as an NC resident, that may pay for most or all of the costs; at a more typical medical school, that may pay for half to two thirds of the costs. Either way, you will have much lower debt than you would have if you spent the money on undergraduate. Higher debt for a new MD will constrain your career and life choices, forcing you to chase the short term money at every decision, instead of being able to consider options that may pay somewhat less or have a delayed financial reward.