ETSU Quillen College of Medicine (MD) Medicine InterviewFormat, Questions & Prep Tips

What do you know about health in Appalachian Tennessee, and why does this specific regional context motivate you to train at Quillen?

Reference specific Northeast TN health data: opioid mortality rates, cancer corridor along the Appalachian ridgeline, cardiovascular disease burden, tobacco use, food insecurity in mountain communities. Show genuine engagement, not vague rural sympathy.

How has your exposure to veterans' healthcare shaped your understanding of medicine, and how do you plan to use the Quillen VA partnership?

If you have veteran exposure, be specific. If not, show you have researched the VA's unique patient population: complex multi-morbidity, PTSD, traumatic brain injury, MST, substance use disorders, and end-of-life care.

A patient presents requesting opioids for chronic back pain after having previously been flagged in the PDMP for doctor shopping. How do you approach this visit?

This is central to Appalachian practice. Discuss non-judgmental assessment, PDMP review, urine drug screening, functional goals vs. pain scores, addiction medicine referral, multimodal pain management, and the risk of abandoning a patient with legitimate pain needs.

Northeast Tennessee communities have been severely affected by the opioid epidemic. What systemic changes would you advocate for as a physician in this community?

Reference harm reduction (naloxone distribution, needle exchange), SAMHSA funding, buprenorphine waiver (now removed under DATA 2000 reform), PDMP improvement, mental health integration in primary care, and community health worker programs.

How would you approach a first visit with an Appalachian patient who has deeply held distrust of the healthcare system based on past negative experiences?

Acknowledge the legitimacy of medical distrust in Appalachian communities (historical experimentation, disrespect, geographic abandonment). Show patience, listening before advising, respecting lay health knowledge, and long-term relationship-building.

What research question about Appalachian or rural health would you most want to investigate during your time at Quillen?

Be specific — opioid recovery outcomes in rural TN, cancer screening disparities in mountain communities, telehealth feasibility in broadband-limited areas, food insecurity and diabetes in Johnson City metro, veteran mental health in rural areas.

A terminally ill veteran at the VA asks you to help them end their life more quickly. How do you respond in this specific context?

Address VA-specific regulations (no MAID in federal facilities), palliative care and hospice resources within the VA system, veteran-specific end-of-life challenges (service-related trauma, isolation), and ensuring the patient does not feel abandoned.

Do you plan to stay in Appalachian Tennessee after residency? What would it take to commit to a long-term practice here?

Be honest and thoughtful — discuss loan repayment (NHSC, state programs), the rewards of community-based longitudinal care, and what personal factors affect your commitment decision. Avoid false certainty if you genuinely don't know yet.

Describe a time you worked with a patient or community member whose health behaviors you found difficult to understand from your own background. How did you respond?

Show genuine curiosity and suspension of judgment. Focus on understanding context (economic, cultural, historical) before offering advice. Avoid any tone of superiority about health literacy or lifestyle choices.

Tobacco use remains extremely prevalent in Northeast Tennessee communities. A patient smokes two packs a day and tells you they have no interest in quitting. How do you proceed?

Demonstrate motivational interviewing approach — brief advice, assess readiness, not lecturing. Discuss harm reduction options, recording the conversation, respecting autonomy while documenting risks, and keeping the door open for future engagement.

[Role-play] You are a Quillen student in a rural Northeast Tennessee clinic. A patient in recovery from opioid use disorder is anxious that a new clinician will treat them as 'just an addict' and is reluctant to discuss their pain honestly. Respond to the patient.

Lead with non-judgemental respect; acknowledge the stigma they have faced. Build trust, separate the person from the diagnosis, and reassure them that honest information helps you care for them safely. Central to Appalachian practice, which Quillen prioritizes.

An interviewer shows you County Health Rankings data for several Northeast Tennessee counties, worse on most measures than the state and national averages. How do you interpret this, and what more would you want to know before drawing conclusions?

Distinguish ranking from cause; name structural drivers (poverty, geographic isolation, tobacco, opioid burden, limited specialist access) and confounders. Connect to Quillen's Appalachian mission without over-reading a single ranking.

An older Appalachian patient relies on traditional remedies and family advice and is sceptical of a treatment you recommend. How do you discuss it without dismissing their knowledge or their community?

Cultural humility, respecting lay and family health knowledge, motivational interviewing, and finding safe integration rather than confrontation. Quillen weights this highly given documented medical distrust in Appalachian communities.

Tell me about a time you became genuinely curious about why a community had worse health outcomes than its neighbors, and what you did to understand it better.

Show self-directed inquiry into rural or Appalachian health drivers rather than assigned work. Connect to the ETSU Center for Appalachian Health's research focus and demonstrate the curiosity-plus-action pattern Quillen values.

Tell me about a time you stayed and kept working at something in a place others were leaving. What did that teach you about commitment?

Quillen needs physicians who will stay in Appalachia rather than rotate through. Use a genuine example of durable commitment and connect it honestly to the retention question — avoid false certainty if you are still deciding.