There are some schools that are super focused on regional students. For instance, In Washington State, WSU specifically seeks students from Eastern Washington, about 2/3s of which come from Spokane (trhe town the school is in) and UW has both Seattle and Spokane campuses with preference for each campus going to those from either western or eastern washington, respectively (With half of western washingtonians living in or near seattle and 2/3 of eastern washingtonians living in/around Spokane.) Knowing that my two state schools do this, I could imagine that other state schools do this as well. Granted, these are the only two medical schools in a 600 mile radius...so they definitely can have a bias.