Without a at least some clinical volunteering (expect range 200+ hours) a med school applicants will not be considered not matter how good their MCAT score is.
Med schools want people who understand the lifestyle and career they are signing up for. There are 10+ applicants for every available med school seat. Med schools can afford to be picky.
RE: LACs not in big cities. Medical volunteering doesn’t have to be in s hospital. It can be at a county health clinic, a doctor’s office, a small, community hospital that offer limited services, a county or private nursing home, an adult daycare program, with a county EMT squad, at a campus-based student health clinic. Lots places that aren’t large, urban or suburban hospitals.
Also as @thumper1 mentioned, many pre-meds do clinical volunteer (or paid) work in the summers.