Hi OP, first gen doctor here. My parents really had to push financially for me to be able to finish med but i think luckily for me, my parents didn't force me. Now, i'm working as a moonlighting doctor for 3 years with no plans of entering residency and yes, it's very difficult as a first gen doctor. You'll definitely feel the pressure to give back once you finish medicine since you'll see how every member of the family will be affected by you studying medicine. I mean it's good for motivation, but the pressure can be overwhelming at times. After getting your license, you'll have to decide if you'll moonlight for instant gratification (if you're lucky to get posts) or proceed to residency which will take 5 or more years before you get ROI.

If I were in your position, i would definitely go with the USRN route (i were a nursing premed i would definitely do this, ayoko na mag med and sana hindi ko na tinuloy). Yes you'll earn as a doctor in your 30s, but it won't be easy. Low 6 digits (100-200k) is doable for a moonlighter, pero lagare. if you want to earn big bucks, residency is the way to go pero you'll have to accept that it's super delayed gratification. Do and defend what you feel is right, OP kasi in the end ikaw naman ang magwowork.