By Ilana Kowarski

Experts say that future doctors with an interest in public service should consider a career in rural medicine.

Practicing medicine in a rural community where doctors are few and far between can be a daunting prospect, but medical school professors and students who concentrate on rural medicine say that the challenge is worth taking on.

Experts say rural medicine can be fascinating because of the variety of health problems that doctors confront on a daily basis. Because rural doctors are often either the only doctor in a town or one of very few doctors in a region, experts say they are called upon to perform a wider-range of procedures than their peers in areas where doctors are plentiful.

"It helps keep your mind fresh with the many different things that could walk through the door," says Dr. Michael Maharry, a clinical associate professor of family medicine with the University of Iowa's Carver College of Medicine and director at the school's Carver Rural Iowa Scholars Program. "It could be gynecology, it could be psychiatry or orthopedic issues, and so your skill set needs to be broad to be able to manage that."

For those considering a rural medicine concentration either during medical school or in residency programs, here are five questions to ask to decide whether it is the right choice for you.

1. Are you passionate about public service? Experts say rural medicine typically requires practitioners to be more resourceful than doctors in a community that has abundant access to medical care, which means that it is important to have a sense of mission.

Dr. Adam Law, clinical assistant professor of medicine at Weill Cornell Medical College at Cornell University and chair of the graduate medical education committee with Cayuga Medical Center, says: "One of the things that motivates people to go to medical school is to help people, and I think there's an enormous need in rural areas. And it can be an extraordinarily satisfying career to go out there and make a difference and become an important member of a community."

2. Is a rural lifestyle attractive to you? Experts say where you enjoy living is a matter of personal preferences and those preferences are important to evaluate before specializing in rural medicine. For instance, expert say, if you enjoy having easy access to cultural amenities, rural medicine might be a poor fit, but if your hobbies are more outdoors-focused, rural medicine may allow you the access to nature that you crave.

3. How valuable is it to you to feel appreciated for your work? Experts say patients in communities that lack doctors tend to be grateful for the services that doctors provide.

“I’ve had a practice in a rural underserved setting; I’ve had a practice in a suburban community that is a part of a larger metropolitan area. And while I have loved the patients that I have taken care of in both areas, and most of them actually were incredibly grateful, I found that there was something very special about those patients that I worked with in those rural areas," says Dr. William J. Burke, dean and associate professor of family medicine with the Ohio University Heritage College of Osteopathic Medicine.

Burke says medical students who are interested in rural medicine ought to get clinical experience in these communities so they can see whether they enjoy it. "You can read about it, you can hear somebody else talk about it, but until you get that opportunity to get your feet wet – so to speak – and to see what it's like, and to work with another health care provider that is in one of those communities, you really don't know."

4. Are you interested in reducing your debt load? Experts say prospective rural medicine students should consider loan forgiveness programs offered at the school, state or federal level that encourage doctors to practice medicine in rural, underserved areas.

At the University of Iowa's Carver College of Medicine, for instance, medical school graduates who then work in rural Iowa communities for five years receive $100,000 total through the school, which they can use to repay their student loans. Many states in the Midwest and the South offer monetary incentives to medical students to encourage them to concentrate on rural medicine.

Shea Jorgensen, a fourth-year medical student at the University of Iowa, says she takes tremendous comfort in the fact that a chunk of her loans will be repaid if she does the type of medicine she dreams of doing – psychiatric rural medicine.

5. How much money do you want to make? Experts say, although rural doctors are often paid more than their peers within the same specialty in urban areas to entice them to practice in rural areas instead, there is a significant financial penalty for focusing on primary care, which is the type of medicine most lacking in rural regions.

Jorgensen says when choosing a specialty, medical students should think about more than money. "I would never choose a medical specialty based on salary," she says. "I think it would lead to burnout pretty quickly."