Best & Worst States to Practice In (2019)

[atomheart]

I’d agree with a meh place for family but they are for the most part so rural one would insane to worry about pollution overload. LA has more pollution than any place in WV lol. Per capita pollution is probably ridiculously high in WV but cumulative load? Not so much in most towns. Have you been to either one? I lived in KY for a while it’s not great but it’s not that bad. WV is pretty crappy for the most part though

Yeah I live in the South where I see population density as a double edged sword. Personally I see the value in open space, but simple trends in geopolitics and economics don't favor these communities in the next twenty or thirty years when I'll be working. Investing in a place like WV is a much bigger risk than the top places on that list except for perhaps Hawaii and CA (which I'm strongly biased against due to current tax concerns and future climate change concerns). In a sense choosing a state to live in is much like buying a home... For those that have never purchased a home, you don't just want to get the most house you can for your dollar, you need to consider community factors like schools too.

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[Cheeni17]

Yeah I live in the South where I see population density as a double edged sword. Personally I see the value in open space, but simple trends in geopolitics and economics don't favor these communities in the next twenty or thirty years when I'll be working. Investing in a place like WV is a much bigger risk than the top places on that list except for perhaps Hawaii and CA (which I'm strongly biased against due to current tax concerns and future climate change concerns). In a sense choosing a state to live in is much like buying a home... For those that have never purchased a home, you don't just want to get the most house you can for your dollar, you need to consider community factors like schools too.

I agree wv is totally going down hill wouldn’t want to own anything there. It’s so hard to predict the next place people will want to live. I’m guessing the west in the next 30 years but I’m probably wrong lol. It just sounds the most hipster. West as in between Kansas and California I should say. Those states seem to be appealing

 

[atomheart]

I agree wv is totally going down hill wouldn’t want to own anything there. It’s so hard to predict the next place people will want to live. I’m guessing the west in the next 30 years but I’m probably wrong lol. It just sounds the most hipster. West as in between Kansas and California I should say. Those states seem to be appealing

Pretty easy to see trends already. People are moving away from rural spaces and urban space is sprawling outward. The more rural an area is the less access it has to modern services and people are just poor out there. Find a mid-sized city with solid infrastructure. Don't move to Atlanta or Denver.

 

[Cheeni17]

Was speaking more in which parts of country not living setting but I agree with the above. Rural is ded

 

[ArdorAyurveda]

Pretty easy to see trends already. People are moving away from rural spaces and urban space is sprawling outward. The more rural an area is the less access it has to modern services and people are just poor out there. Find a mid-sized city with solid infrastructure. Don't move to Atlanta or Denver.

I like how you think.

Are you saying don't move to Atlanta or Denver because there's too much sprawl? I currently live in Atlanta, and I can't wait to leave precisely because my commute is ridiculous.

What cities would you suggest? Indianapolis? Ann Arbor? Las Vegas? Portland? Seattle? Minneapolis? Or are you suggesting places like Boise, Iowa City, Fargo?

As I think about places where I want to apply for residency, I almost feel at a loss. Not too many places in the US with good public transportation options besides places like NYC, Chicago, Philly, DC...all of which are pretty expensive -_-

 

[ArdorAyurveda]

For those consider MN. Just read this from Anestheia forum.

Minnesota Medical Association - MN Supreme Court Rules Physician-Patient Relationship is Not Necessary to Sue Docs for Malpractice

absolutely ridiculous. thanks for bringing this to light!

 

[NukHopkins]

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[WoundupKnight]

Nevada with its 0% state income tax though >.>
I'd like to go to residency somewhere nice, but on the other hand it seems like you'll be too busy to enjoy living somewhere nice.

 

[atomheart]

I like how you think.

Are you saying don't move to Atlanta or Denver because there's too much sprawl? I currently live in Atlanta, and I can't wait to leave precisely because my commute is ridiculous.

What cities would you suggest? Indianapolis? Ann Arbor? Las Vegas? Portland? Seattle? Minneapolis? Or are you suggesting places like Boise, Iowa City, Fargo?

As I think about places where I want to apply for residency, I almost feel at a loss. Not too many places in the US with good public transportation options besides places like NYC, Chicago, Philly, DC...all of which are pretty expensive -_-

I think the article is pretty good as a guide for after residency. However, I am graduating to one of the states on the list already knowing the Midwest is strong and worthy of investment. For residency I wanted to get into a city, but I only applied to one of those cities you listed and I didn't rank it high. There are plenty of cities in the United States and several without the Boston, NYC, LA, SF, Philly, DC, or Seattle price tags. Buying a used car and moving to a flyover state is certainly more favorable than putting up with the cost of living in the big coastal cities.

 

[Cheeni17]

absolutely ridiculous. thanks for bringing this to light!

I can image the phone call from the nurse practitioner. Probably butchered the patient presentation and told the doc a bunch of wrong info

 

[IMGASMD]

I think the article is pretty good as a guide for after residency. However, I am graduating to one of the states on the list already knowing the Midwest is strong and worthy of investment. Consider Reno instead of Vegas...Tucson instead of Phoenix...

For residency I wanted to get into a city, but I only applied to one of those cities you listed and I didn't rank it high. There are plenty of cities in the United States and several without the Boston, NYC, LA, SF, Philly, DC, or Seattle price tags.

Chicago? Too cold and probably somewhat pricey? Milwaukee? Kinda cold too.
Denver? Pricey for “Midwest”
SLC? Isn’t this the thread people were talking about diversity?
Austin? Houston?

Let me get on my soapbox for a bit. This is when your school/residency will open doors for you. There may be a practice who’s making a good living in the big cities, but they are started by someone from T5 school/residency and only take people from those places..... rest of us, making “average salary”, just to survive.

 

[IMGASMD]

I can image the phone call from the nurse practitioner. Probably butchered the patient presentation and told the doc a bunch of wrong info

I thought it was a interesting conversation amongst physicians. Also tells you as a group we are not as homogeneous as I thought.

 

[Cheeni17]

I thought it was a interesting conversation amongst physicians. Also tells you as a group we are not as homogeneous as I thought.

Yeah I read it it was pretty interesting.

 

[Chibucks15]

Chicago? Too cold and probably somewhat pricey? Milwaukee? Kinda cold too.
Denver? Pricey for “Midwest”
SLC? Isn’t this the thread people were talking about diversity?
Austin? Houston?

Let me get on my soapbox for a bit. This is when your school/residency will open doors for you. There may be a practice who’s making a good living in the big cities, but they are started by someone from T5 school/residency and only take people from those places..... rest of us, making “average salary”, just to survive.

There's no way every lucrative practice is run by somebody from a T5. And the rest of us making "average". I mean come on I know this is SDN but that's absurd. 2/3 of patients don't know or care where you did residency or went to school. They just care that you make them better and aren't a dbag.

EDIT: I know DO docs who set up a great practice and make some damn good money. And that's back when DOs were barely practicing docs. Nowadays, it isn't out of the question to make great money as a DO or regular MD if you have some business sense

 

[IMGASMD]

There's no way every lucrative practice is run by somebody from a T5. And the rest of us making "average". I mean come on I know this is SDN but that's absurd. 2/3 of patients don't know or care where you did residency or went to school. They just care that you make them better and aren't a dbag

I am not saying they all are. I am saying there are practices, the bar to get in is a good pedigree.
And there are patients especially in these cities only want doctors from T5 schools and they can afford it.

 

[Chibucks15]

I am not saying they all are. I am saying there are practices, the bar to get in is a good pedigree.
And there are patients especially in these cities only want doctors from T5 schools and they can afford it.

They aren't the majority. I'm from a major city and have never encountered this. Idk where you've seen enough of this to make yourself believe its like law school

 

[IMGASMD]

They aren't the majority. I'm from a major city and have never encountered this. Idk where you've seen enough of this to make yourself believe its like law school

I’ve interviewed at two practices and basically got laughed out. Did my residency at a uber suburbia, so maybe?

 

[DO2015CA]

Chicago? Too cold and probably somewhat pricey? Milwaukee? Kinda cold too.
Denver? Pricey for “Midwest”
SLC? Isn’t this the thread people were talking about diversity?
Austin? Houston?

Let me get on my soapbox for a bit. This is when your school/residency will open doors for you. There may be a practice who’s making a good living in the big cities, but they are started by someone from T5 school/residency and only take people from those places..... rest of us, making “average salary”, just to survive.

Colorado isn’t the Midwest

 

[SLC]

Colorado isn’t the Midwest

Ever been east of Denver? It is out there, at least culturally and geographically/geologically.

Western half, no, eastern half of the state is all prairie.

 

[nimbus]

Ever been east of Denver? It is out there, at least culturally and geographically/geologically.

Western half, no, eastern half of the state is all prairie.

Isn’t that called Nebraska?

 

[IMGASMD]

Isn’t that called Nebraska?

Made that drive once. As far as I know, just flat, open field, with no humans.

 

[DO2015CA]

Ever been east of Denver? It is out there, at least culturally and geographically/geologically.

Western half, no, eastern half of the state is all prairie.

I have

 

[68PGUN]

There's no way every lucrative practice is run by somebody from a T5. And the rest of us making "average". I mean come on I know this is SDN but that's absurd. 2/3 of patients don't know or care where you did residency or went to school. They just care that you make them better and aren't a dbag.

EDIT: I know DO docs who set up a great practice and make some damn good money. And that's back when DOs were barely practicing docs. Nowadays, it isn't out of the question to make great money as a DO or regular MD if you have some business sense

It's not true for 95% of the specialties out there. However, for Anesthesiology, they're run mostly by pretentious insecured docs who regularly take crap from surgeons, and care deeply about the DO vs MD title as well as your place of training. So, don't go into Anesthesiology if you don't want to be judged by your DO status even at the attending level. It's fairly obvious after perusing their forum when all the MDs talk about discounting a DO applicant by 10-15 USMLE points in comparison to a subpar MD applicant. It's a joke.

I did an elective with a DO Anesthesiologist who was trained at a fairly elite place in California, and was completely turned off by the field and his insecurity. People are free to think or act in whatever manner they wish. However, I want to be judged by my merits and work ethics, rather than the circumstances pushing me to be a DO instead of a MD.

So, keep that in mind. There are definitely some elite Anesthesiology practice groups in TX and CA who will only take MDs trained at elite places. But, those kind of circumstances exist bc the job market for desirable places is very competitive, especially in Anesthesiology. The more competitive something is, the more stupid the judging process becomes.

 

[IMGASMD]

The more competitive something is, the more stupid the judging process becomes.

I agree totally this statement. I say “Don’t hate the player hate the game.” I am perfectly content with where I am.

I don’t think this is necessary just an anesthesia problem. I’ve seen very competitive IM specialities’ private groups that would do this. I’ve even seen private hospitalist group, certainly not as high of a bar, but fairly selective.

Edit: clarification. I will also apologize to people thinking that I am just here to stir things up. I just checked the sub that I am in.
Full disclosure. I am a MD and anesthesiologist. I was also trained in internal medicine. I promise I am not here throw any shade on anyone or anything. Merely just pointing out, in the real world, where you end up in school and residency matters, especially if you’re not in primary care.

 

[atomheart]

Chicago? Too cold and probably somewhat pricey? Milwaukee? Kinda cold too.
Denver? Pricey for “Midwest”
SLC? Isn’t this the thread people were talking about diversity?
Austin? Houston?

Let me get on my soapbox for a bit. This is when your school/residency will open doors for you. There may be a practice who’s making a good living in the big cities, but they are started by someone from T5 school/residency and only take people from those places..... rest of us, making “average salary”, just to survive.

From an anesthesia perspective are you referring to 300-400k vs 1mil+ incomes?

If the job market is anything like my interview season, DOs going into gas are already getting laughed out of coastal cities. This leaves flyover America except for places like Denver and Dallas that are already saturated with MD talent.

 

[IMGASMD]

From an anesthesia perspective are you referring to 300-400k vs 1mil+ incomes?

If the job market is anything like my interview season, DOs going into gas are already getting laughed out of coastal cities. This leaves flyover America except for places like Denver and Dallas that are already saturated with MD talent.

Mommy track ~220
Mom and pop small private 350 ~ 500
AMC starting ~375k probably stay there
Heavy hitters ~600+

Are we talking getting into residency or going into work force? I’ve had a few DO attendings when I was training and currently working with DOs at my shop.

If you actually spend any time in the anesthesia sub, you’d see how hard some of us are dissuading people from going into it. But that’s SDN for you. ¯\_(ツ)_/¯

From what I’ve gathered, (I actually looked into Denver and even Utah, trying to fulfill my dream as a ski bum), those places are also saturated with AMCs. Unless you know someone, you’ll be working for the man, regardless.

 

[atomheart]

Mommy track ~220
Mom and pop small private 350 ~ 500
AMC starting ~375k probably stay there
Heavy hitters ~600+

Are we talking getting into residency or going into work force? I’ve had a few DO attendings when I was training and currently working with DOs at my shop.

If you actually spend any time in the anesthesia sub, you’d see how hard some of us are dissuading people from going into it. But that’s SDN for you. ¯\_(ツ)_/¯

From what I’ve gathered, (I actually looked into Denver and even Utah, trying to fulfill my dream as a ski bum), those places are also saturated with AMCs. Unless you know someone, you’ll be working for the man, regardless.

I've read the sub and knew about the job market and crazy politics before making the jump. For the record, the other subs are also full of doom talk... except for I guess pain. For now anesthesia continues to put out higher earnings than most primary care gigs, and we're all watching for what happens during our careers.

Other guy in thread was asking about getting into a city from a residency point of view... I guess with the understanding that they could make some good local connections to a job. Most of the students on this forum are trying to get into the best residency that will still let in DOs with an assumption that the long game will play out well... From the standpoint of getting into a gas residency as a DO, it's best to take a good hard look at the Midwest or forgotten holes in the northeast/southeast that have been deemed undesirable because there's a good chance that's where many of us will end up in the next decade.