Hello:
I have been working in GIS since more than 7 years, for an electrical multinational company in my country (Spain). I work fundamentally with a GIS software called Smallworld, although I have had the opportunity to also use some others (ArcInfo, AutoCAD...). Smallworld is a database oriented to cartography working, designed to manipulate an enormous amount of data, and has its own programming language.
From my experience, and in a general way, would be necessary:
1. - Knowledge of Databases, SQL and XML.
2. - A programming language (I advise JAVA) and Web oriented technologies (HTML, Javascript, JSP, PHP,...).
and would be desiderable:
3. - Technical knowledge on graphic file formats (tiff, png...).
4. - Knowledge of CAD software (AutoCAD, MicroStation..) and graphic treatement (Photoshop).
5. - Knowledge of geodesy and cartography (projections, coordinate systems, GPS...)
I put some examples:
1) At this moment, I am project manager and developer of an application that publishes maps in the Web using the OpenLayers javascript library (www.openlayers.org). This application is (or better say: will be) a Web Map Server, a very fashionable type of applications (google maps is an example of it). [To work with me you would need Javascript, JSP, Smallworld, Web Design and Beer Drinking knowledge... but not english language, as you can see]
2) Digitalization: some governmental organizations (city councils) need to have vector maps of their bounds. [ You need just drawing with CAD software and little else].
3) Generation and treatment of maps: a company that sells cartography to other companies needs to have a good amount of maps made and prepared to sale [ autoCAD, photoshop, graphic file formats ]
4) Developing an opensource GIS (for example: gvGIS). [ JAVA, geodesy and cartography, databases, ... you need to know everything :-( ]
5) Commonly, a development of a GIS adapted to the logic of business of a company [ a programming languaje, databases and usually a commercial GIS program such as ESRI ArcInfo, Geomedia,... which one? it depends of the amount of money the company wants to expend ;-) ].
6) A friend of mine (he is pilot of airplanes) was required for taking aerial photographs (he just flies... another guy was carring the camera). I do not know if this is really to work in cartography, but me friend thinks so. :-))
I don´t think you have to move yourself to a big city to work in GIS projects, but I suppose there will be more opportunities.
Of course, it is only my point of view, but I hope that can be usefull. If you need more information, keep me in touch.
Khani.
p.d: thanks to babelfish to help me in translation :-))