Also, getting over it will be 10 times easier while he is far away, and you have your family and friends. If he follows through? You'll be so glad to know he really wants it too, and was just a little commitment-shy. It sounds like you were both young when you first started dating, so maybe a little distance will help him gain perspective - for better or for worse.

This is really good advice, thanks! He also suggested this, as a way to enable me to search for a job at my own pace (in case I don't find one and he needs to move sooner than I'm ready).

Honestly, from what you've written, it seems like he's not that into it. In fact, I wouldn't be surprised if on some level he might be hoping you'll give the ultimatum and he'll get to go start med school as a free single man while you get to look like the marriage-crazy one and he dodged a bullet.

I dunno about this one. He loves me a lot and has expressed (many times) that he does want to get married; I think he has a phobia, though, and when it comes down to it (and this is what really matters) he gets paralyzed. I really don't know how to overcome that, or if it's my place to nudge him.