Turning down that med school acceptance might cost more than you think. Listener “my initials are ARM” got into medical school—cue the confetti—but now that reality’s set in, she’s not feeling great about her only acceptance. The school is small, expensive, and far from home. Should she go anyway or risk reapplying in hopes of a better fit next year? MD/PhD students Michael Arrington, Shruthi Kondaboina, Jessica Smith, and M1 Maria Schapfel weigh the real costs of walking away from an acceptance, from the red flags admissions committees look for to the gamble of getting in again. They get honest about finances, family, and the very unsexy truth about how much the campus “vibe” actually matters. Plus, what to say if you do it anyway. Bonus: the MD/PhD students dish about why they took that road, while Maria counters with why MD is better for her.