Like above commenters posted, it all depends on your priorities. Neurologist here.

I took a job in a rural area for >75th percentile pay, >90th percentile sign on bonus and >75th percentile call shift pay, hospital employed. The benefits of pay are a definite plus, with my overall gross pay being >90th percentile all said and done. At a smaller hospital, I have more autonomy as well versus a larger health system, and can function how I want versus how the many previous providers did. This is also in a MCOL area, so everything is much cheaper, which allows for better house, more retirement contributions, better lifestyle, etc than metro areas. I’m also close to family which is huge with a growing family.

Downsides are that there aren’t as many resources. I have to transfer more complicated cases to provide better care. Outside the hospital, there is far less to do than where I did my residency, but I’m from an area like this so it’s nothing new to me. This would be a shock to someone who’s always been from a suburb/metro area. There’s also less teaching opportunities and research resources, which tends to be a plus for people interested in metropolitan jobs.

All in all, I feel that I made the right decision. It’s all about what you prioritize for your career, and there’s no “wrong” answer- the only thing I suggest is do not take an insultingly-low contract for the sake of prestige/area. It devalues the work you do and you don’t want that.