Brain Drain: The States Struggling To Retain Their Medical Talent

Key Points

Many states struggle to retain medical talent.
Physician retention rates are higher than 75% in the best states, and lower than 40% in the worst.
Low physician retention rates exacerbate existing doctor shortages and can lead to reduced health care outcomes.
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As the U.S. health care system faces mounting shortages of physician shortages, state and federal leaders are scrambling to improve workforce pipelines. Yet in many states, the problem isn’t just training enough doctors – it’s convincing them to stay.

New physicians often leave the state where they trained, and in some parts of the country, retention rates are alarmingly low. In the states with the weakest retention, fewer than 40% of doctors stay to practice after completing their residency, while the top-performing states boast retention rates above 75%. At the state level, retention rates are correlated with factors like health care salary as well as outcomes like mortality due to medical error. A closer look at the data reveals the states with the lowest physician retention rates.

To determine the states with the lowest physician retention rates, 24/7 Wall St. reviewed data on physician retention from the Association of American Medical Colleges. States were ranked based on the percentage of physicians who are practicing in the same state where they completed their residency. Retention rates are based on individuals who completed residency between 2013 and 2022.

Supplemental data on median annual salary for health care practitioners and technical occupations are from the Bureau of Labor Statistics Occupational Employment and Wage Statistics program and are for May 2024. Data used to calculate the average dollar amount of medical malpractice payouts per resident from 2015 to 2024 are from the National Practitioner Data Bank of the U.S. Department of Health & Human Services and the U.S. Census Bureau’s Population and Housing Unit Estimates program, while data on mortality due to medical and surgical complications from 2021 to 2023 are from the CDC’s WONDER database.

50. California

Physicians practicing in state of residency: 77.5%
Concentration of physicians: 315.6 per 100,000 residents (122,963 total)
Median annual salary for healthcare practitioners: $119,990
Deaths from medical and surgical care complications, 2021-2023: 0.6 per 100,000 people
Average medical malpractice payout, 2015-2024: $299,154

49. Alaska

Physicians practicing in state of residency: 70.8%
Concentration of physicians: 289.6 per 100,000 residents (2,124 total)
Median annual salary for healthcare practitioners: $102,660
Deaths from medical and surgical care complications, 2021-2023: 1.0 per 100,000 people
Average medical malpractice payout, 2015-2024: $515,917

48. Texas

Physicians practicing in state of residency: 66.5%
Concentration of physicians: 243.1 per 100,000 residents (74,164 total)
Median annual salary for healthcare practitioners: $79,510
Deaths from medical and surgical care complications, 2021-2023: 1.2 per 100,000 people
Average medical malpractice payout, 2015-2024: $229,548

47. Idaho

Physicians practicing in state of residency: 66.4%
Concentration of physicians: 192.7 per 100,000 residents (3,786 total)
Median annual salary for healthcare practitioners: $79,780
Deaths from medical and surgical care complications, 2021-2023: 1.3 per 100,000 people
Average medical malpractice payout, 2015-2024: $503,098

46. Florida

Physicians practicing in state of residency: 65.0%
Concentration of physicians: 286.5 per 100,000 residents (64,791 total)
Median annual salary for healthcare practitioners: $80,020
Deaths from medical and surgical care complications, 2021-2023: 0.9 per 100,000 people
Average medical malpractice payout, 2015-2024: $304,022

45. Montana

Physicians practicing in state of residency: 63.4%
Concentration of physicians: 248.6 per 100,000 residents (2,816 total)
Median annual salary for healthcare practitioners: $79,850
Deaths from medical and surgical care complications, 2021-2023: 1.2 per 100,000 people
Average medical malpractice payout, 2015-2024: $375,543

44. Oregon

Physicians practicing in state of residency: 61.6%
Concentration of physicians: 318.1 per 100,000 residents (13,468 total)
Median annual salary for healthcare practitioners: $108,070
Deaths from medical and surgical care complications, 2021-2023: 1.1 per 100,000 people
Average medical malpractice payout, 2015-2024: $593,962

43. Maine

Physicians practicing in state of residency: 60.2%
Concentration of physicians: 379.2 per 100,000 residents (5,293 total)
Median annual salary for healthcare practitioners: $82,860
Deaths from medical and surgical care complications, 2021-2023: 0.9 per 100,000 people
Average medical malpractice payout, 2015-2024: $586,353

42. Oklahoma

Physicians practicing in state of residency: 59.2%
Concentration of physicians: 254.1 per 100,000 residents (10,300 total)
Median annual salary for healthcare practitioners: $76,160
Deaths from medical and surgical care complications, 2021-2023: 1.0 per 100,000 people
Average medical malpractice payout, 2015-2024: $299,186

41. North Dakota

Physicians practicing in state of residency: 59.1%
Concentration of physicians: 315.3 per 100,000 residents (2,472 total)
Median annual salary for healthcare practitioners: $77,750
Deaths from medical and surgical care complications, 2021-2023: 1.1 per 100,000 people
Average medical malpractice payout, 2015-2024: $368,061

40. Georgia

Physicians practicing in state of residency: 59.0%
Concentration of physicians: 272.9 per 100,000 residents (30,100 total)
Median annual salary for healthcare practitioners: $81,520
Deaths from medical and surgical care complications, 2021-2023: 1.0 per 100,000 people
Average medical malpractice payout, 2015-2024: $548,590

39. Minnesota

Physicians practicing in state of residency: 59.0%
Concentration of physicians: 342.1 per 100,000 residents (19,632 total)
Median annual salary for healthcare practitioners: $95,380
Deaths from medical and surgical care complications, 2021-2023: 1.0 per 100,000 people
Average medical malpractice payout, 2015-2024: $786,892

38. Mississippi

Physicians practicing in state of residency: 58.4%
Concentration of physicians: 245.3 per 100,000 residents (7,211 total)
Median annual salary for healthcare practitioners: $64,960
Deaths from medical and surgical care complications, 2021-2023: 1.6 per 100,000 people
Average medical malpractice payout, 2015-2024: $326,381

37. Indiana

Physicians practicing in state of residency: 58.4%
Concentration of physicians: 269.9 per 100,000 residents (18,519 total)
Median annual salary for healthcare practitioners: $78,330
Deaths from medical and surgical care complications, 2021-2023: 1.3 per 100,000 people
Average medical malpractice payout, 2015-2024: $249,288

36. Washington

Physicians practicing in state of residency: 58.4%
Concentration of physicians: 310.8 per 100,000 residents (24,280 total)
Median annual salary for healthcare practitioners: $103,660
Deaths from medical and surgical care complications, 2021-2023: 1.2 per 100,000 people
Average medical malpractice payout, 2015-2024: $545,386

35. Colorado

Physicians practicing in state of residency: 58.1%
Concentration of physicians: 289.4 per 100,000 residents (17,011 total)
Median annual salary for healthcare practitioners: $86,740
Deaths from medical and surgical care complications, 2021-2023: 0.9 per 100,000 people
Average medical malpractice payout, 2015-2024: $467,492

34. Louisiana

Physicians practicing in state of residency: 58.0%
Concentration of physicians: 304.8 per 100,000 residents (13,939 total)
Median annual salary for healthcare practitioners: $69,940
Deaths from medical and surgical care complications, 2021-2023: 1.0 per 100,000 people
Average medical malpractice payout, 2015-2024: $260,824

33. South Dakota

Physicians practicing in state of residency: 57.7%
Concentration of physicians: 278.0 per 100,000 residents (2,556 total)
Median annual salary for healthcare practitioners: $69,510
Deaths from medical and surgical care complications, 2021-2023: 0.5 per 100,000 people
Average medical malpractice payout, 2015-2024: $688,143

32. Arkansas

Physicians practicing in state of residency: 56.8%
Concentration of physicians: 257.4 per 100,000 residents (7,895 total)
Median annual salary for healthcare practitioners: $67,930
Deaths from medical and surgical care complications, 2021-2023: 1.6 per 100,000 people
Average medical malpractice payout, 2015-2024: $403,338

31. Arizona

Physicians practicing in state of residency: 56.2%
Concentration of physicians: 268.6 per 100,000 residents (19,961 total)
Median annual salary for healthcare practitioners: $87,750
Deaths from medical and surgical care complications, 2021-2023: 0.9 per 100,000 people
Average medical malpractice payout, 2015-2024: $451,285

30. Massachusetts

Physicians practicing in state of residency: 56.2%
Concentration of physicians: 526.2 per 100,000 residents (36,840 total)
Median annual salary for healthcare practitioners: $97,790
Deaths from medical and surgical care complications, 2021-2023: 0.8 per 100,000 people
Average medical malpractice payout, 2015-2024: $764,434

29. Alabama

Physicians practicing in state of residency: 54.9%
Concentration of physicians: 262.5 per 100,000 residents (13,410 total)
Median annual salary for healthcare practitioners: $64,590
Deaths from medical and surgical care complications, 2021-2023: 1.0 per 100,000 people
Average medical malpractice payout, 2015-2024: $572,647

28. Illinois

Physicians practicing in state of residency: 54.8%
Concentration of physicians: 371.0 per 100,000 residents (46,563 total)
Median annual salary for healthcare practitioners: $82,960
Deaths from medical and surgical care complications, 2021-2023: 1.0 per 100,000 people
Average medical malpractice payout, 2015-2024: $709,014

27. New York

Physicians practicing in state of residency: 54.8%
Concentration of physicians: 474.4 per 100,000 residents (92,846 total)
Median annual salary for healthcare practitioners: $99,890
Deaths from medical and surgical care complications, 2021-2023: 0.9 per 100,000 people
Average medical malpractice payout, 2015-2024: $502,292

26. Michigan

Physicians practicing in state of residency: 54.7%
Concentration of physicians: 409.4 per 100,000 residents (41,090 total)
Median annual salary for healthcare practitioners: $81,880
Deaths from medical and surgical care complications, 2021-2023: 0.9 per 100,000 people
Average medical malpractice payout, 2015-2024: $254,431

25. Wisconsin

Physicians practicing in state of residency: 54.0%
Concentration of physicians: 333.5 per 100,000 residents (19,713 total)
Median annual salary for healthcare practitioners: $81,620
Deaths from medical and surgical care complications, 2021-2023: 0.9 per 100,000 people
Average medical malpractice payout, 2015-2024: $620,748

24. Kansas

Physicians practicing in state of residency: 53.9%
Concentration of physicians: 307.5 per 100,000 residents (9,043 total)
Median annual salary for healthcare practitioners: $75,120
Deaths from medical and surgical care complications, 2021-2023: 1.5 per 100,000 people
Average medical malpractice payout, 2015-2024: $219,428

23. Utah

Physicians practicing in state of residency: 53.5%
Concentration of physicians: 251.9 per 100,000 residents (8,610 total)
Median annual salary for healthcare practitioners: $79,440
Deaths from medical and surgical care complications, 2021-2023: 1.0 per 100,000 people
Average medical malpractice payout, 2015-2024: $333,200

22. Ohio

Physicians practicing in state of residency: 53.4%
Concentration of physicians: 380.6 per 100,000 residents (44,852 total)
Median annual salary for healthcare practitioners: $79,130
Deaths from medical and surgical care complications, 2021-2023: 1.3 per 100,000 people
Average medical malpractice payout, 2015-2024: $482,997

21. South Carolina

Physicians practicing in state of residency: 53.2%
Concentration of physicians: 272.2 per 100,000 residents (14,626 total)
Median annual salary for healthcare practitioners: $77,920
Deaths from medical and surgical care complications, 2021-2023: 1.1 per 100,000 people
Average medical malpractice payout, 2015-2024: $353,118

20. Nevada

Physicians practicing in state of residency: 53.1%
Concentration of physicians: 208.7 per 100,000 residents (6,667 total)
Median annual salary for healthcare practitioners: $92,980
Deaths from medical and surgical care complications, 2021-2023: 1.0 per 100,000 people
Average medical malpractice payout, 2015-2024: $345,945

19. New Mexico

Physicians practicing in state of residency: 52.8%
Concentration of physicians: 322.0 per 100,000 residents (6,809 total)
Median annual salary for healthcare practitioners: $84,380
Deaths from medical and surgical care complications, 2021-2023: 1.5 per 100,000 people
Average medical malpractice payout, 2015-2024: $376,700

18. North Carolina

Physicians practicing in state of residency: 52.7%
Concentration of physicians: 298.9 per 100,000 residents (32,386 total)
Median annual salary for healthcare practitioners: $79,210
Deaths from medical and surgical care complications, 2021-2023: 1.2 per 100,000 people
Average medical malpractice payout, 2015-2024: $377,515

17. Missouri

Physicians practicing in state of residency: 52.7%
Concentration of physicians: 361.5 per 100,000 residents (22,402 total)
Median annual salary for healthcare practitioners: $76,400
Deaths from medical and surgical care complications, 2021-2023: 0.8 per 100,000 people
Average medical malpractice payout, 2015-2024: $398,180

16. Vermont

Physicians practicing in state of residency: 52.4%
Concentration of physicians: 417.3 per 100,000 residents (2,702 total)
Median annual salary for healthcare practitioners: $84,660
Deaths from medical and surgical care complications, 2021-2023: 1.3 per 100,000 people
Average medical malpractice payout, 2015-2024: $435,447

15. Nebraska

Physicians practicing in state of residency: 52.2%
Concentration of physicians: 350.0 per 100,000 residents (6,925 total)
Median annual salary for healthcare practitioners: $79,420
Deaths from medical and surgical care complications, 2021-2023: 1.3 per 100,000 people
Average medical malpractice payout, 2015-2024: $381,935

14. Virginia

Physicians practicing in state of residency: 51.0%
Concentration of physicians: 314.1 per 100,000 residents (27,376 total)
Median annual salary for healthcare practitioners: $81,700
Deaths from medical and surgical care complications, 2021-2023: 0.9 per 100,000 people
Average medical malpractice payout, 2015-2024: $493,490

13. Kentucky

Physicians practicing in state of residency: 50.9%
Concentration of physicians: 283.5 per 100,000 residents (12,830 total)
Median annual salary for healthcare practitioners: $76,380
Deaths from medical and surgical care complications, 2021-2023: 1.3 per 100,000 people
Average medical malpractice payout, 2015-2024: $378,136

12. West Virginia

Physicians practicing in state of residency: 50.9%
Concentration of physicians: 328.5 per 100,000 residents (5,814 total)
Median annual salary for healthcare practitioners: $69,340
Deaths from medical and surgical care complications, 2021-2023: 1.3 per 100,000 people
Average medical malpractice payout, 2015-2024: $346,587

11. Hawaii

Physicians practicing in state of residency: 49.4%
Concentration of physicians: 309.5 per 100,000 residents (4,442 total)
Median annual salary for healthcare practitioners: $104,000
Deaths from medical and surgical care complications, 2021-2023: 0.7 per 100,000 people
Average medical malpractice payout, 2015-2024: $634,281

10. Pennsylvania

Physicians practicing in state of residency: 49.1%
Concentration of physicians: 418.3 per 100,000 residents (54,224 total)
Median annual salary for healthcare practitioners: $80,250
Deaths from medical and surgical care complications, 2021-2023: 1.0 per 100,000 people
Average medical malpractice payout, 2015-2024: $464,328

9. New Jersey

Physicians practicing in state of residency: 48.4%
Concentration of physicians: 364.2 per 100,000 residents (33,838 total)
Median annual salary for healthcare practitioners: $100,350
Deaths from medical and surgical care complications, 2021-2023: 0.8 per 100,000 people
Average medical malpractice payout, 2015-2024: $514,257

8. Maryland

Physicians practicing in state of residency: 48.2%
Concentration of physicians: 444.6 per 100,000 residents (27,475 total)
Median annual salary for healthcare practitioners: $95,620
Deaths from medical and surgical care complications, 2021-2023: 0.9 per 100,000 people
Average medical malpractice payout, 2015-2024: $445,997

7. Tennessee

Physicians practicing in state of residency: 47.5%
Concentration of physicians: 297.6 per 100,000 residents (21,208 total)
Median annual salary for healthcare practitioners: $75,830
Deaths from medical and surgical care complications, 2021-2023: 1.3 per 100,000 people
Average medical malpractice payout, 2015-2024: $328,741

6. Iowa

Physicians practicing in state of residency: 47.3%
Concentration of physicians: 275.4 per 100,000 residents (8,833 total)
Median annual salary for healthcare practitioners: $74,430
Deaths from medical and surgical care complications, 2021-2023: 1.1 per 100,000 people
Average medical malpractice payout, 2015-2024: $528,284

5. Connecticut

Physicians practicing in state of residency: 45.6%
Concentration of physicians: 451.4 per 100,000 residents (16,328 total)
Median annual salary for healthcare practitioners: $97,450
Deaths from medical and surgical care complications, 2021-2023: 0.8 per 100,000 people
Average medical malpractice payout, 2015-2024: $711,861

4. Rhode Island

Physicians practicing in state of residency: 42.9%
Concentration of physicians: 434.4 per 100,000 residents (4,761 total)
Median annual salary for healthcare practitioners: $90,690
Deaths from medical and surgical care complications, 2021-2023: 1.1 per 100,000 people
Average medical malpractice payout, 2015-2024: $561,605

3. Wyoming

Physicians practicing in state of residency: 41.1%
Concentration of physicians: 254.4 per 100,000 residents (1,486 total)
Median annual salary for healthcare practitioners: $81,210
Deaths from medical and surgical care complications, 2021-2023: 2.2 per 100,000 people
Average medical malpractice payout, 2015-2024: $581,247

2. New Hampshire

Physicians practicing in state of residency: 40.8%
Concentration of physicians: 318.4 per 100,000 residents (4,464 total)
Median annual salary for healthcare practitioners: $88,160
Deaths from medical and surgical care complications, 2021-2023: 1.0 per 100,000 people
Average medical malpractice payout, 2015-2024: $665,406

1. Delaware

Physicians practicing in state of residency: 39.2%
Concentration of physicians: 364.6 per 100,000 residents (3,762 total)
Median annual salary for healthcare practitioners: $87,840
Deaths from medical and surgical care complications, 2021-2023: 0.9 per 100,000 people
Average medical malpractice payout, 2015-2024: $447,059

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