A combination of personal attributes and social capital gained through family, educational, and social connections gave rural students the capacity to overcome barriers and attend college and medical school. The rural population is one of the nation's largest medically underserved populations and physician shortages are negatively influencing both the health status and economic vitality of rural areas. The lived experiences of 18 physicians who grew up in a rural area were explored using a modified Van Kaam method of phenomenological analysis. Key themes exposed included: personal attributes, importance of educators, family, peers, and faith, presence or absence of barriers to college or medical school, financing, prior health care exposure, and feelings and memories connected with college or medical school.

A physician maldistribution exists when comparing rural with urban areas. It is necessary to ensure rural citizens have available, accessible, and acceptable quality medical care to remedy health disparities resulting from the lack of physicians. Using theories of symbolic interactionism and experiential place integration as the lenses for analysis, I sought to study the phenomenon of becoming a rural physician and the experiences that influenced physicians to choose rural practice. This was a qualitative study using a transcendental phenomenological approach. Fifteen individual interviews were conducted. For the participants in this study, rural upbringing, family values, early experiences regarding medicine, and identity in place were experiences prior to medical school that influenced the desire to practice and live in a rural area. Rural clinical medical school and residency experiences, the culture of the medical school, and preceptor relationships were experiences during medical school that influenced physicians' choices. Family, partners, and loan forgiveness were experiences that influenced practice type and location. Professional support and integration into the community were experiences influencing retention.

The purpose of this study is to identify the key problems associated with recruitment and retention of primary care physicians in rural areas. Research will determine what these key problems are and how to effectively develop solutions to decrease the shortage of rural physicians. The intent of this study is to show that there are many factors that contribute to physician shortages and that strategies should to be developed to decrease these numbers.

Although fourteen percent of the U.S. population lives in rural areas, only ten percent of primary care physicians practice medicine there; populations in areas with physician shortages have measurably worse health outcomes. We analyze the effects of incentive programs intended to eliminate physician shortages. Using a differences-in-differences approach, we estimate that student loan forgiveness programs cause an increase of three physicians per rural county. We then estimate a model of physician location decisions and find that physicians are unresponsive to differences in compensation and prefer to live in their home state. Consequently, current programs are too small to eliminate shortages.