This question cannot be answered without a resounding (but unsatisfying) “it depends.”
Have you tried the online Net Price Calculators for your son’s top-choice East Coast schools? Although I always take NPC results with a block of salt, they can be a good starting point if you want to get at least a ballpark sense of what your family contribution is likely to be.
If your son is admitted to any of the snazziest of the East Coast colleges, and you are indeed a family of very limited means, he may receive an excellent financial aid “package” which could include very little loan or even no loan at all.
So before losing too much sleep over the decision, I advise you to …
a. Do the Net Price Calculators to see if this helps to allay your fears
b. Wait until your son has his admission verdicts (and I realize this isn’t easy)
While I certainly agree that you don’t want your son to be burdened by debt when he graduates, especially with med school ahead of him, the opportunity to attend a top college or university with an international student body (and reputation) could justify taking on some debt because of the value of the broadening experience and of the lifelong contacts it will provide.
On the other hand, if he attends the local public university, he may be in a better position to stand out in a crowd and snag the juiciest research gigs and internships which, in turn, will fortify his med school applications down the road.
But it’s really impossible to provide accurate advice without knowing exactly where your son has been admitted and exactly how much debt he may have to take on.
Keep in mind, too, that it’s not too late for your son to consider some other colleges where he may be a contender for big merit bucks … places that would allow him to travel out of state but without accruing debt. These colleges may not offer the prestige of the most sought-after institutions, but they could provide a broadening experience along with the chance for you son to stay on track for med school.
Please write back again when your son receives his full list of acceptances and aid awards and remind me of our exchange today. Once your son has his actual decisions … and dollar amounts … in front of him, I can advise you more responsibly.