Honestly I think something that’s important (maybe more important than direct ETX ties) is showcasing your commitment to rural primary care for this school or at the very least showing you have longitudinal healthcare experience in ETX.
Looking back at my application, pretty sure I only received an interview was because they saw I was from ETX and sent an auto invite. But after the interview they probably went back and gave my app a deep dive and could tell I didn't have any rural healthcare experience and minimal primary care. Also I went to college outside the region and all my experiences are in urban settings.
Guess what I'm trying to say is this school seems to be one of the very few that actually looks for mission fit above everything else. I wouldn’t take it as your application not being good enough, but more so they’re really looking for a specific applicant and I respect that.