How do OOSers from faraway states get into schools that only accept residents of neighboring states?

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Ex.: U of North Dakota, Marshal Edwards, other schools explicitly say they only accept their own residents and those from the states they border, yet the MSAR says they have students from states from all over the country.

Is it just because they have close ties to those states?
 
Some schools are more open to OOS candidates who are being admitted for MD/PhD studies or who bring something to the table that would otherwise be missing (e.g. URM, veteran, etc). That would be my first thought to explain what seems like a contradiction.
Could it be because they fit well with the school's mission? I personally am interested in rural medicine which is why I bring up those two schools.
 
Everyone sings a nice song but unless you have a ton of experience living and working/volunteering in rural settings, it comes across as B.S. and you won't be considered a good fit with the mission. If they can fill their seats with in-state applicants who fit with the mission, that will be their preference.
 
Ex.: U of North Dakota, Marshal Edwards, other schools explicitly say they only accept their own residents and those from the states they border, yet the MSAR says they have students from states from all over the country.

Is it just because they have close ties to those states?
Another possibility is that the students have lived in those states at a previous time.

And don't forget legacies! I know of two people who were accepted at some of the schools mentioned above because their parents were grads of the school.
 
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