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1. Look there's nothing wrong with you not wanting to move or not being sure how serious you are about her but you should have been able to see this coming a mile off. She was in the latter half of med school when you met. It's been pretty much a given that she will be moving at this time for the your entire relationship. It's a little selfish and immature that you have not thought about this until now. I'm not trying to be overly harsh but there are some important lessons here that you need to learn for the coming years.

   You're 31. I understand that this is your first serious relationship but the majority of your dating pool is going to be looking at long term compatibility. That doesn't mean everyone is trying to jump into marriage asap but at your age people who do want long term/marriage/kids are looking at dating as a process for finding and evaluating potential life partners. The crossroads are all the time. You need to be clear and communicative about what you are looking for. Unless your relationship was explicitly casual, you should have considered in the first month of knowing her if you would be willing to move in a year, and if so, then spent a year finding out if she was someone worth that commitment for you. When you break up with her, she's probably going to say that you wasted her time, and she will be right.

   You need to be really honest with her tonight and it would probably help to be humble and apologetic too. You have a few hours to figure out what your own life parameters. Are you looking for a long term partner, and would you be willing to move for a relationship not specifically for her but in general. Would you move for adventure regardless of long term commitment? That sounds like no. If would want a long term partner would you be willing to move with them somewhere for 3-7 years or permanently?

   I'd recommend something like the following

   I should have seen this coming and I feel a bit foolish that I didn't. I'm feel a bit caught off guard and unsure about things. That's not fair to you and I'm sorry.

   AND

   I am happy with the life I've built here and don't want to move. I enjoy our relationship and would love to continue seeing you until you start your residency but I won't be moving with you and I don't want to do long distance so I guess our relationship would have an expiration date. I want the best for you and I'd still like to help you rank residencies for you.

   OR

   I am happy with the life I've build here and I don't want to move or do long distance. I'm sorry I didn't realize we'd come to this crossroads so soon but I don't want to lead you on or waste your time. I think we should break up.

   OR

   I really like my life here and I hadn't considered that I would need to move to continue our relationship. I really enjoy your company and I might be willing to move for you but I hadn't given it serious thought until recently. I need some time to figure out where I'm at. Can I help you rank residencies by what's best for you and continue to see where our relationship goes. I can commit to figuring out by (April? At least 1-2 months before she would be moving) if I will move with you.

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2. Exactly what I said

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