This qualitative study describes the phenomenon of becoming a rural physician and the experiences that influence physicians to choose and stay in rural practice. 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 experiences during medical school and residency, the culture of the medical school, and preceptor relationships were factors that influenced physicians’ choices. Family, partners, and loan forgiveness were factors that influenced practice type and location. Professional support and integration into the community were factors influencing retention. This information is valuable to medical educators, administrators, and community leaders interested in addressing the maldistribution of physicians and, ultimately, health disparities affecting rural citizens.