He did say "200k in debt when we got married," which suggests to me at least that he is talking about all of her debt, from undergrad and medical school.
Still, $250k is a shitload of debt. Putting back a solid $2k/month towards the principal (not even counting interest here) would still take a little over ten years to pay it off.
State University of New York Undergrad including all expenses is about $22K per year (just checked) or about $90K
The NY State Med School Tuition is about $30K per year or $120K + living expenses.
So for around $250K one can get both Undergrad and Medical Education.
A number of people graduating from medical school have large debt precisely because they do not choose to go to both public undergrad AND public medical school.
4 years undergrad private school can be about $250 K for tuition and living costs. Thus, by choosing to attend public undergrad and medical school can cost the same as private undergrad alone.