yes, this is a universal phenomenon actually. even in the US the mid-west ‘rural’ areas are always in need of specialists and competent physicians, but the difference here is that these area hospitals pay their doctors very very well as compared to urban hospitals so money is not the issue here. school districts are not that good in these areas, amenities and entertainment are very basic thus effecting quality of your life thus the decision to stay and practice around bigger cities where the market is already saturated but one is able to give ones family a better life. same could be said for Pakistan, where in addition to there being no money, the amenities and basic facilities are almost non-existent, you possibly cannot move with your family and sacrifice their needs as well, including good schooling. one has to look at the whole picture, not just one angle of it.