Honestly, I feel like you are over thinking this. If you actually want to go to Spokane, then you should interview in Spokane to show you want to do that. They're not going to think you're desperate. The school would not hold it against someone to switching their preference to Spokane after they announced the change in the interview process and also asked people if anyone wanted to change their preference. That would be pretty shady and unethical of them to hold that against someone, and they're not trying to trick you.
Same thing with the TRUST program..... .....if they really have a concern for why you didn't apply for it, they will ask you directly and you can explain yourself. You don't have to have had rural medical experience to say that you're interested in it....being from a MUA and also understanding the challenges of MUA is good reason enough if you explain why it interests you. Also they're definitely not going to expect (or even want) EVERYONE in Spokane to be interested in MUA. They will still want a diversity of people and interests in that group, and they also know that not everyone ends up practicing in the field/place that they thought they would. Spokane itself is not even MUA.
Let's say that even IF some of these hypothetical things you bring up might be slightly true, admissions in Seattle is still probably going to be tougher because of the sheer numbers of people that want to go there. Finally, I wouldn't look at it if you fit better for "admissions purposes" or for "what will get me in" but rather for where YOU want to go to medical school. That is what ultimately makes the best fit, and if you really want to go to Spokane, that will come through in your interview and only help you.
I know what it's like as an applicant thinking that admissions people will think "x, y, and z" if I say or do "a, b, c" but in reality they're just looking if you're a decent person with good people skills, if you know what you're getting yourself into, and if you know really know why medicine is a good fit for you.
So wait. Did anyone else get that "are you sure you don't want to go to Spokane" email? If so, have you been offered an interview already as well?
Sorry to harp on this but I'm still having an internal conflict about whether or not to change my primary to Spokane. I had said no preference before with the secondary (other than a slight preference to interview in Seattle because I live here, but no preference for where I'd like to attend) but I had been leaning towards it and TRUST internally. I decided against TRUST for now but practicing in/being from a MUA is my whole bag but I was thinking there was a good chance I'd end up in Spokane anyway.
Now this email is making it sound like I actually have to designate Spokane as my primary choice if I'm interested in going there? But I'm afraid if I switch now 1) it will look like I'm desperate and going for the smaller competition and 2) I feel like the fact that I'm not applying for TRUST will work against me ("if you're so interested in that then why aren't you going for TRUST?") and 3) I may be less competitive compared to the other Spokane-interested candidates for what they may be looking for out there compared to Seattle and what they're looking for, since I don't have a ton of rural related anything.
Then I'm afraid that if I say I want Seattle now that it sounds like Seattle interviews are ONLY for Seattle (and not both like I thought) then I won't be competitive compared to all the fanciest flashiest Seattle candidates and won't get in that way either. Argh. I wish I could just interview with everyone and have them put me where they think I belong :/
