Karen Gedney qualified as a doctor in the mid-1980s. In the US, this has never been a cheap undertaking; today the average American medical student emerges with around $170,000-worth of debt, and some sources put the total cost of becoming a doctor much higher. But Gedney’s studies were financed by the National Health Service Corps, which provides scholarships for healthcare providers. The payoff is a period of public service in areas where there is a shortage of medical professionals.

Dr. Karen Gedney From medical doctor to mentor "Retirement is about ikigai,” said Karen Gedney, 63, who retired four years ago from her job as a senior physician at the Nevada Department of Corrections medical center in Carson City. The Japanese word translates as a sense of purpose and meaning and a feeling of well-being.

Karen Gedney drove up to the Northern Nevada Correctional Center, a compound of gray buildings, chain-link fences and guard towers in Carson City. Her heart pounded. Her mouth went dry. She summoned her courage and walked across the parking lot to the gatehouse. She announced that she was there to start her new job as prison doctor. Several years earlier, she’d accepted a full scholarship to med school in return for a four-year appointment in an underserved area.