Measure 110 context, SUD without coercion, harm reduction for active drug use.

Providing care to a patient experiencing homelessness, housing as healthcare, tent city health.

Gender-affirming care, trans health, PrEP access, navigating religious provider conscientious objection.

Oregon Health Plan prioritization, Medicaid coverage limits, who decides what is covered.

Oregon Death with Dignity Act, MAID ethics, conscientious objection, patient autonomy.

The Oregon Health Plan created the first explicit Medicaid prioritization list in the US — rationing coverage by condition priority rather than eligibility category. Know the ethical arguments for and against.

Oregon's Death with Dignity Act (1997) was the first MAID law in the US. Know the safeguards, the ethical debates, and OHSU's clinical role in implementation.

Measure 110 (2020) decriminalized personal drug possession and directed drug offense fines to treatment programs. The 2024 partial reversal reflected challenges in implementation. Know both.

Portland has one of the highest unsheltered homeless rates per capita in the US. OHSU students participate in street medicine — providing care in encampments and shelters.

Harm reduction in street medicine means meeting patients where they are: providing wound care for injection sites, naloxone, safe use supplies, without requiring sobriety.

Housing is healthcare — understand the housing first model and why it improves health outcomes better than treatment-first approaches.

Portland is one of the most LGBTQ+ dense cities in the US. OHSU students will care for trans patients, provide gender-affirming care, and discuss PrEP — these are clinical competencies, not optional topics.

Know the difference between sexual orientation and gender identity in health documentation and care.

For conscientious objection scenarios: OHSU explicitly expects providers to ensure patient access regardless of personal beliefs.

"Since 2011 I've sat on MMI panels across Canada, the USA, and the UK — scoring thousands of candidates across medicine, dentistry, PA, and nursing. Universal MMI is built on everything I've learned sitting on the other side of that table."

Oregon created the first explicit Medicaid rationing system — a ranked list of condition-treatment pairs by cost-effectiveness and benefit. Medicaid covers treatments above the funding line; those below are not covered. It is ethically controversial but designed to be transparent and equitable.

Oregon's Ballot Measure 110 (2020) decriminalized personal possession of all drugs — replacing criminal charges with $100 fines and referrals to health assessments. In 2024, the legislature partially reversed it after implementation challenges. The full arc is the relevant case study.

Oregon's 1997 Death with Dignity Act was the first US law permitting physician-assisted death for terminally ill adults. Safeguards include two physician confirmations, mental health evaluation, and multiple waiting periods. OHSU faculty helped develop its implementation.

OHSU is public and prices tuition differently for Oregon residents. Approximately 65% of the entering class are Oregon residents, with Pacific Northwest regional candidates representing a significant portion of out-of-state students.

Recent entering classes have median MCAT around 513 and median GPA around 3.7. OHSU values Oregon/Pacific Northwest ties, policy engagement, and community health commitment.

OHSU operates a formal street medicine program where faculty, residents, and students provide healthcare directly in Portland homeless encampments and shelters. It is one of the most active street medicine programs at a US academic medical center.

The Confederated Tribes of Warm Springs, Confederated Tribes of Grand Ronde, Confederated Tribes of Siletz, and Confederated Tribes of the Umatilla Indian Reservation are the major Oregon tribes. Missing and Murdered Indigenous Women (MMIW) is an active public health crisis in Oregon.

Pacific Northwest wildfires (particularly 2020's record fire season) create PM2.5 air pollution that affects cardiovascular, respiratory, and mental health. OHSU researchers study these impacts and Oregon Public Health has integrated wildfire response into its air quality protocols.