The authors set themselves a research task - to create a generalizing image of the zemstvo doctor on the example of the Urals. The initial hypothesis is the idea of civilizational changes in the Russian reality of the second half of the XIX - early XX centuries, associated with the formation of elements of civil society and the underlying processes of changes in the self-consciousness of the Russian intelligentsia. The uniqueness of the phenomenon of the "zemsky doctor" in the history of world medicine is emphasized, its role in preserving the life of the rural population of the country, the formation of a new attitude to sanitation issues and personal hygiene. It is noted that the level of professional training of the zemsky doctorwas provided by a high level of medical education in the leading universities of the country. The peculiarity of their activity was the universality associated with the insufficient number of medical personnel in rural areas. By the beginning of the XX century the trend towards the creation of specialized medical care is making its way. This process was especially clearly manifested in the provincial Alexander Zemsky hospital, and then seized the district city hospitals and individual centers of factory medicine. The desire of doctors for professional association, regular exchange of experience through professional societies, provincial congresses of doctors, at meetings of medical and sanitary councils, as well as on the basis of the results of scientific association, regular exchange of experience through professional societies, provincial congresses of doctors, at meetings of medical and sanitary councils, as well as on the basis of the results of scientific scientific councils, as well as on the results of scientific scientific councils, as well as on the results of academic trip. An analysis of objective difficulties in the activities of zemskie doctors, their relations with the local population, the leadership of zemskie institutions is given. The author's vision of the causes of selflessness and stoic patience to the social conditions of life of zemskie doctors is revealed. Attention is drawn to their active participation in public life, often as initiators of public events in their territories, the establishment of trusting relations with the population on the example of combating child mortality, the work of sanitary and school guardianships, children's shelters, the dissemination of hygienic knowledge, etc. The merits of zemskie doctors in the organizational life of zemstva are reflected, their role in the political events of that time, the organization of medical care for wounded and sick soldiers during the First World War are evaluated. In conclusion, reasonable conclusions are made about the characteristic features of the typical appearance of zemskie doctors, prospects for further study of this topic are outlined.