I understand your position OP. My girl and I were in the same graduating class. She now does Urgent Care/ Family Practice while I do Cardiology. Everyone in this field, down to the drug reps, have large diamond rings. While your girlfriend (future wife) may not care so much about the ring, she and you will be judged based off it. It's easy to say not to care about what others think but it's hard to actually have to face it on a daily basis.
Personally I went with a 1/2 carat center stone with .33 carat total weight channel set side stones for her promise ring. For the engagement ring I plan on just upgrading the center stone to a 1-1.5 carat. It's large enough to say you aren't cheap but not too outlandish. Also at 1-1.5 it won't rip too many latex gloves. You also have to make sure you don't anything that sits up too high or she will hate it being a doctor; unless she goes into a specialty where she doesn't use her hands too often.
Oh, and I also recommend an accompanying silver or gold plain band. Something to swap out with when doing activities where you don't want to damage or lose the diamond ring. When we go hiking, snorkeling, etc my girl always swaps out her ring. You can get a nice silver band for 25-50 bucks or a nice plain gold band for about 100-150. Cheap insurance for when you know there is risk depending on the activity
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