This paper presents a case study analysing a rural health career ladder program's (HCL) influence on students' career aspirations toward health care fields. Rural students enrolled in a career ladder program were interviewed to assess the effectiveness of early experience on career choice. Although limited to one institution, the findings shed light on the ways that institutional characteristics, policies, and practices may effectively influence rural youth career aspirations. The study provides useful information to counselors, parents, school administrators, and education policy makers to put in place experiential strategies to guide students into making health career choices achievable. The data was analyzed using an in vivo coding method to study relationships among factors that affect student career decisions. Drawing on the findings, the recommendations of the paper are to keep current hands-on activities and to provide profession-based mentors for rural students to encourage careers in rural health care. [The dissertation citations contained here are published with the permission of ProQuest LLC. Further reproduction is prohibited without permission. Copies of dissertations may be obtained by Telephone (800) 1-800-521-0600. Web page: http://www.proquest.com/en-US/products/dissertations/individuals.shtml.]