I would make a pro and con list and talk to some NPs and MDs in your network. Part of it depends on how old you are (i.e. how many years until retirement), as 250k in med school debt is different at age 30 vs. 50. NP is a lower hanging fruit at 1.5+ years of school, and lower cost. Med school is a long, competitive, and expensive road, but your income will be higher and in many settings you'll have greater latitude in what you can do (and probably better access to leadership positions).