Hi Christine, well the thing is... when asking for money it is good to get to the heart of the matter. I feel like this one is less-than-inspiring at the start, because right away it implies that she'll be able to do it either way, but it would just be nice to not have a big debt. And the obvious question is, "Why do YOU deserve special treatment?" So it makes me think it is better to 1.) give a clear plan so they know you are serious, 2.) burden the with the responsibility of knowing that you truly desire make a meaningful contribution as a physician and that your future depends, in part, on their decision with this scholarship.
As for "well-known territory"... I don't know, you might be right. It depends on how the admissions officer thinks, I guess.
Your post made me have the insight that it is relevant to talk about post-academic plans in this kind of essay only to the extent that you successfully convey the idea that winning a scholarship will effect post-academic plans
If you don't need the scholarship, your post academic plans will be affected very little by whether or not you get it. But the way to make them give you the scholarship is to show that it will indeed make a difference, which is the whole point of a scholarship. Ideally, one's post academic plans should be of central interest in determining whether or not they should get a scholarship.