@blugrn6, unless things have drastically changed, I think if you extend a year, you just pay an extra year of tuition at whatever rate you’re currently at: in-state, regional, or out-of-state. I don’t think you pay OOS tuition, regardless, for the rest of the time you’re in the program. If that’s the case, that majorly sucks, but I doubt it, as parents would truly raise a ruckus.
I also agree, if you’re coming here Year 1, with the intent already to take a year off to do research somewhere, I wouldn’t do the program. Every single person who I knew that took a year off to do research, did so after seeing how their application looked and then made a decision - sometimes it was because they were going for a competitive specialty, sometimes it was because they were truly exhausted from the pace of the program and needed a year to regroup and thus took a research year in their field they were going for. I don’t know one person who came in already planning to take a year off. Taking a year off during medical school is a decision that is made very carefully and looking at things from all angles.
Everyone came into the program wanting to graduate with our Bachelor degree and MD in 6 years, which is what sets UMKC (and I guess NEOMED) apart from every other medical school in the country. But life and all that it encompasses happens, so some people voluntarily take a year off, for whatever reason.