WSU Elson S. Floyd College of Medicine (MD) Medicine InterviewFormat, Questions & Prep Tips

WSU Floyd was founded specifically to address the physician shortage in rural eastern Washington. How does that mission connect to your goals as a physician?

Reference your ties to the Inland Northwest, eastern Washington, or comparable rural/underserved regions. Articulate why rural or community practice appeals to you with specific motivating experiences. Interviewers probe whether the mission fit is genuine or strategic.

What do you think it would be like to be the only physician in a town of 3,000 people in eastern Washington? What would excite you about that role, and what would concern you?

Show intellectual honesty about both the rewards (breadth, relationships, community impact) and the challenges (professional isolation, scope-of-practice limits, on-call demands). WSU Floyd trains for exactly this reality.

You are practising in a rural eastern Washington town. A local farm employee comes in with occupational injuries consistent with unsafe working conditions. He asks you not to report anything because he fears deportation. What do you do?

Address the tension between patient autonomy (wish for non-disclosure), mandatory reporting of occupational hazards (OSHA), immigration status and fear of legal consequences, and the duty of confidentiality. Explore options: anonymous occupational safety reporting, connecting with legal aid resources, and treating the immediate injury without coercion.

A tribal elder requests that you not share information from a patient's medical visit with a family member who is the patient's designated healthcare proxy. The patient is cognitively impaired and cannot reliably consent. What are your obligations?

Address the tension between the legally designated proxy's rights under HIPAA, tribal cultural values about health information, the patient's best interests, and the limits of your ability to override legal designations unilaterally. Discuss involving tribal health liaisons and an ethics consultation.

A patient who works as a wheat farmer in the Palouse has been advised to stop working for six weeks following back surgery. He says he cannot afford to stop — harvest is in two weeks. How do you counsel him?

Agricultural livelihoods and medical compliance are in direct tension here. Explore his specific concerns, the medical risk of early return, partial activity modifications, eligibility for agricultural worker disability programmes, and who else in the family or community might assist. Avoid a binary "follow orders or face consequences" approach.

Eastern Washington has disproportionately high rates of opioid overdose mortality relative to western Washington. What factors explain this disparity, and what physician-level interventions could help?

Reference structural factors: fewer treatment facilities, rural social isolation, agricultural injury rates driving prescription opioid use, lower insurance rates. Physician-level interventions: DEA X-waiver/DATA 2000 for buprenorphine prescribing (now integrated into DEA registration), naloxone co-prescribing, PDMP use, and bridge prescribing.

You are the only provider in a rural clinic and you receive a request to provide care you are not trained to perform. What is the ethical framework for deciding how to respond?

Discuss the duty to provide within scope of competency, the obligation to do no harm via beyond-scope interventions, emergency exception to scope (EMTALA), telemedicine consultation as a bridge, and the systemic issue of physician shortage that creates this dilemma. Avoid both abandoning the patient and overstepping dangerously.

Describe your connection to eastern Washington, the Inland Northwest, or a comparable rural or underserved region. How has it shaped your view of medicine?

Authenticity is critical here. If you grew up in Spokane, Yakima, or a rural town, share the specific health disparities you witnessed. If your connection is more indirect (family, rotations, research), explain how it motivated a genuine career orientation toward this region.

A patient who has never seen a physician before has come to your clinic as part of a community health outreach programme. She is wary and uncommunicative. How do you begin building trust?

Demonstrate patient-centred first-contact skills: start with her concerns, not your agenda; use open-ended questions; explain your role and the boundaries of confidentiality; avoid jargon; acknowledge the barriers that kept her from care before. Do not rush to the clinical assessment.

Should incentive programmes that pay physicians extra to practise in rural Washington be expanded? What are the ethical considerations?

Reference the J-1 visa waiver programme, state rural physician loan repayment schemes, National Health Service Corps, and the HPSA designation system. Discuss autonomy and financial incentive ethics: are physicians being coerced, or is this a fair compensation for a social good? Engage with the evidence on whether financial incentives actually retain rural physicians long-term.

Role-play: I am an orchard worker in the Yakima Valley. You have just told me my back injury means I should not lift for several weeks, and I am telling you I cannot afford to stop — I will lose the job. The assessor will play the patient — counsel me.

Take the economic reality seriously rather than restating the restriction. Explore modified-duty options, workers'-compensation or disability resources, who else might help, and the genuine medical risk of early return. Assessors reward candidates who treat agricultural livelihoods as part of the clinical picture, not an obstacle to compliance.

You are shown data showing opioid-overdose mortality is markedly higher in several rural eastern Washington counties than in the Seattle metro, despite lower prescribing rates in some of those counties. How do you make sense of that?

Resist assuming high deaths simply track high prescribing. Discuss treatment-facility scarcity, social isolation, the fentanyl supply, agricultural-injury pathways to dependence, and delayed emergency response in rural areas. Note what data you would examine (treatment access, naloxone distribution). Eastern Washington's disparity is central to the school's mission.

Agricultural work in eastern Washington carries distinctive occupational health risks. What are the major hazards, and how would a primary-care physician approach occupational-health screening for a farmworker population?

Reference pesticide exposure, heat illness, musculoskeletal injury, respiratory hazards, and zoonotic risk. Discuss screening, exposure history-taking, prevention counselling, and the barriers (immigration fear, language, seasonality) to occupational-health follow-up. Demonstrates genuine engagement with the Palouse/Yakima clinical reality WSU Floyd trains for.

A migrant farmworker camp in your catchment has poor sanitation contributing to recurrent illness, but the employer is also your patient and a major local employer. How do you navigate this dual relationship?

Address the tension between public-health duty, patient confidentiality with the employer, and the power imbalance affecting workers. Discuss appropriate public-health reporting channels, advocacy, and avoiding conflicts of interest, while protecting vulnerable workers. Rural communities make such overlapping relationships common.

A patient from a local tribal community is reluctant to follow a referral to an off-reservation specialist, citing past poor experiences with non-tribal providers. How do you respond?

Acknowledge the validity of past experiences, ask what would make care feel safer, and explore options that respect tribal health sovereignty — coordination with IHS or tribal-clinic providers, cultural liaisons. Build trust over time. Tribal and Indigenous health (Spokane, Colville, Yakama nations) is a defining WSU Floyd context.