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Washington’s two biggest universities are squaring off over how to train more doctors to work in rural Eastern Washington, where there’s a critical shortage of primary care physicians.

To remedy that, Washington State University wants to build and operate a new medical school in Spokane — a step that would require several years of accrediting work, at an unknown cost.

The University of Washington, which operates one of only two medical schools in a five-state region, says a better way is to expand an existing program it runs on WSU’s Spokane campus, ultimately creating what in effect would be a new medical school there — but without the accrediting work and administrative overhead a new school would require.