10 Best States for Surgeons to Work

When it comes to building a surgical career you love, with strong pay, smart support systems, and a lifestyle that doesn’t burn you out, location matters. A lot. 

From coast to coast, the experience of being a surgeon can look very different depending on where you hang your white coat.

That’s why we’re continuing our series about the top states for specialist locum tenens. This guide will help you zero in on the states where surgeons have the best possible launch pad for their careers. We’ve broken it down by the metrics that matter most to you: average salaries, locum demand, malpractice climate, academic and hospital infrastructure, and regional quality of life. Whether you're looking for better pay, fewer headaches, or just a fresh start, you'll find a state here that checks the boxes.

Let’s dive into the top spots where surgery careers aren't just surviving- but thriving.

A note on data: Employment rates, location quotients, and salaries come from the Bureau of Labor Statistics. Salaries are based on full time employment data. Locums work may be higher. 

Best States for Surgeons to Work

• Wisconsin
• Minnesota
• Massachusetts
• Maryland 
• Pennsylvania
• Kentucky
• Arizona
• Illinois
• West Virginia
• Indiana
• Let us help you find your next locums role

1. Wisconsin

Wisconsin remains The Big Cheese for a reason: it combines some of the highest average pay in with strong hospital and academic systems. Beyond competitive compensation, Wisconsin offers a robust and collaborative healthcare environment anchored by the University of Wisconsin School of Medicine and Public Health in Madison, a national leader in health services research and rural surgery training. The state features a unique blend of premier academic centers and influential integrated health systems, most notably Mayo Clinic Health System with its significant presence in western Wisconsin and the Aurora Health Care (now part of Advocate Health) network in the east. Furthermore, the state also holds some great opportunities for surgeons in subspecialties like orthopedic surgery.

The moderate cost of living makes this an attractive base for locum surgeons. But it’s also an amazing place for nature lovers who enjoy spending time on the lakes, exploring trails, and enjoying small town amenities.

• Best for: Strong hospital systems, favorable malpractice/tort climate, high pay
  Average salary: ~$449,560 annually 
• Average hourly pay: $270-320/hr
• Location quotient: 2.0 

2. Minnesota

Minnesota’s renowned healthcare landscape profoundly enriches a surgical career. The state is a global epicenter of medicine, home to the Mayo Clinic in Rochester, consistently ranked #1 in the nation, and the University of Minnesota Medical School, a pioneer in surgical innovation and transplantation. Surgeons here engage with world-class subspecialty colleagues, cutting-edge clinical trials, and a deeply embedded culture of multidisciplinary care. Major systems like Allina Health, HealthPartners, and the M Health Fairview network offer diverse practice settings from quaternary academic hospitals to high-quality community hubs, all operating within a state known for exceptional health outcomes and a collaborative, evidence-based ethos.

Locums should keep in mind that cost of living is higher in the Twin Cities, but many locum positions lie outside these metro zones. The state also offers a great mix of urban and rural opportunities, and doctors looking for opportunities for outdoor adventuring will find a lot to love about Minnesota.

• Best for: Academic strongholds, balanced quality of life, high demand
• Average salary: ~$354,930 annually 
• Average hourly pay: $280-330/hr
• Location quotient: 1.7

3. Massachusetts

Massachusetts provides an unparalleled intellectual and academic environment for surgeons. It is the nation’s healthcare and life sciences capital, dense with world-renowned academic institutions. Surgeons have the opportunity to work within or alongside hospitals like Massachusetts General Hospital and Brigham and Women’s Hospital (part of Mass General Brigham), Beth Israel Deaconess Medical Center, and Boston Children's Hospital, all affiliated with Harvard Medical School. Boston’s major centers (MGH, Harvard-affiliated, etc.) drive demand for subspecialists. Pay is lower relative to top Midwest states, but for academic or specialized surgeons, the exposure is invaluable. Cost of living is higher, especially around Boston, so you’ll need to keep this in mind for your financial planning. 

Also of note: malpractice risk is higher in areas with limited tort reform and no general cap on damages. Keep in mind that cities with denser populations have a higher percentage of malpractice claim filings as you balance the pros and cons.

• Best for: Academic, subspecialty opportunities, prestige institutions
• Average salary: $308,410 annually 
• Average hourly pay: $404/hr
• Location quotient: 1.8

4. Maryland

Maryland offers a unique confluence of academic medicine, progressive health policy, and cutting-edge research. The state is home to the National Institutes of Health (NIH) in Bethesda, as well as major academic powerhouses include the Johns Hopkins Hospital in Baltimore, a global leader in surgical specialties and research, and the University of Maryland Medical System, which features a world-class Shock Trauma Center and the Maryland Proton Treatment Center. Though baseline salary data is more modest than in the top few states, locum premiums in HSPAs or for subspecialty coverage can boost your income.

But where Maryland also shines is in its culture and amenities, which are great for families. It has a world-class aquarium in Baltimore, scenic beaches, beautiful state parks and, of course, Chesapeake Bay. It genuinely is the place “where waters and opportunities meet.”

• Best for: East Coast medical hub access, coastal living, institutional variety
• Average salary: ~$332,650 adjusted 
• Average hourly pay: $300-360/hr
• Location quotient (metro): 1.9 in Baltimore region

5. Pennsylvania

Pennsylvania’s healthcare landscape is defined by a rich history of medical education and a competitive, high-density market of prestigious academic centers. The state hosts powerhouse institutions like the Hospital of the University of Pennsylvania (Penn Medicine) and Children's Hospital of Philadelphia in the east, and the University of Pittsburgh Medical Center (UPMC)—a fully integrated $24 billion health system—and Allegheny Health Network in the west. This includes UPMC’s flagship academic hospital, Presbyterian, which is a leader in transplantation and neurosurgery. It’s a strong middle-tier option with good latitude.

Beyond medicine, Pennsylvania offers a compelling quality of life, balancing vibrant, walkable cities with exceptional natural beauty. The state features a lower cost of living than most other Northeast corridors, along with diverse landscapes ranging from the Pocono Mountains and the Great Lakes shore to the rolling farmland of Amish Country.

• Best for: Regional access, mix of urban & rural coverage, institutional depth
• Average salary (adjusted): ~$363,270 
• Average hourly pay: $300/hr
• Location quotient: 1.2

6. Kentucky

A great spot for rural locum physicians, Kentucky’s lower cost of living makes moderate pay stretch further. If you like bourbon, derby season and a host of amenities Louisville provides, we think you might just flourish there. The state’s academic core is the University of Kentucky in Lexington and the University of Louisville, both with strong surgical residencies and research initiatives, particularly in fields like trauma, oncology, and cardiovascular disease. Systems like Baptist Health and Norton Healthcare offer major tertiary centers.

Surgeons here can lead efforts to improve health disparities, participate in population health research focused on Appalachian and rural communities, and often enjoy a high degree of clinical autonomy and rapid practice growth within a need-rich environment. The rural hospital demand for locum surgeons is significant. Be aware: you might have a bit of a commute between your workplace and your living space, depending on the assignment.

• Best for: Rural coverage demand, cost-advantaged practice, flexible scheduling
• Average pay (non‑orthopedic surgeon context): ~$332,610 annually, among top states in surgeon pay rankings 
• Average hourly pay: $260-300/hr 
• Location quotient: 1.3

7. Arizona

With growing populations, aging communities and many underserved rural regions, Arizona is a strong pick for locums surgeons looking to root in a single, secure place. Now this does mean that the state has a more competitive environment, particularly in large metro areas, but outside cities like Phoenix and Tucson there are amazing opportunities to provide critical services to communities that need them. Major academic anchors include the Mayo Clinic Arizona in Phoenix/Scottsdale, a top-ranked integrated campus with a focus on specialty and tertiary care, and the University of Arizona College of Medicine in Tucson and Phoenix, known for its work in telemedicine, aerospace medicine, and biosciences. Large nonprofit systems like Banner Health (which partners with UA for academic medicine) and HonorHealth provide extensive clinical platforms and investment in new technologies. This fast-growing state allows surgeons to be at the forefront of telehealth adoption, destination medicine programs, and building new service lines in a competitive, sunbelt market.

The downside: once again, cost of living in some metro areas can also eat into your earnings. But if you do your homework, you can find places that help control for costs.

• Best for: Demand in remote areas, strong sun belt appeal, institutional growth
• Average pay (surgeons generally): ~$327,520 
• Average hourly pay: $300-350/hr
• Location quotient: 1.5

8. Illinois

Illinois, particularly Chicago, offers a vast, diverse, and intellectually rigorous surgical marketplace. The city is a hub for top-tier academic medicine, featuring the University of Chicago Medicine, Northwestern Medicine, and Rush University Medical Center, all nationally ranked and deeply invested in clinical research and innovation. Downstate, University of Illinois Chicago and Southern Illinois University provide strong academic anchors. Surgeons can access ultra-subspecialized practice, compete for complex regional referrals, and participate in trials across numerous large, competing health systems like Advocate Health and Loyola Medicine. Both major metro centers and rural areas generate consistent demand for quality care as well. So the demand is there. But the amenities are too.

Chicago boasts not only a network of some of the nation’s largest hospital systems and research centers, but also some really great food and entertainment. Cost of living can be high closer to the city and you’ll want to budget time for your commute. Illinois also makes a good central base for locum surgeons covering multiple nearby states.

• Best for: Big-city demand, academic hubs, central U.S. access
• Average salary: ~$319,710 
• Average hourly pay: $300-425/hr
• Location quotient: 1.1

9. West Virginia

West Virginia is a standout for locum surgeons seeking to serve HPSAs and rural areas. The wage data is strong relative to many other states, and the demand for surgical coverage in less-served hospitals is high. Surgeons have the opportunity to be vital leaders in a state with significant healthcare needs. The primary academic center is West Virginia University Medicine, which has grown into a dominant, statewide integrated system providing quaternary care and robust residency programs in Morgantown, Charleston, and beyond. Marshall Health in Huntington is another key academic partner. The environment is ideal for those dedicated to rural surgery, trauma systems development, opioid response initiatives, and hands-on teaching, with strong support for addressing public health challenges through academic-clinical partnerships.

The main things you’ll need to assess are quality of life factors and the malpractice environment, which is significantly more complicated in West Virginia than in any of the surrounding states. Malpractice and infrastructure trade‑offs exist, but locum premiums can compensate.

• Best for: Strong rural demand, locum opportunity, underserved communities
• Average salary: ~$365,560 
• Average hourly pay: $280-310/hr
• Location quotient: 1.6
  

10. Indiana

Indiana offers excellent value: strong hospital systems, lower overhead and cost of living, and the ability to stretch travel assignments across adjacent states. The state is anchored by the Indiana University School of Medicine in Indianapolis, the largest medical school in the U.S., which partners with the statewide IU Health system—a national leader in organ transplantation and orthopedic care. Other major players include the Eskenazi Health trauma center and the Mayo Clinic Care Network-affiliated Franciscan Health. In the north, the University of Notre Dame contributes to bioengineering research. Surgeons in Indiana benefit from a high-volume, clinically focused environment with significant research opportunities through IU, a collaborative rather than fiercely competitive market, and a central location with access to a large patient catchment area.

If Indiana is your locum landing pad, you’ll have quick and easy access to both Illinois and Ohio. And in addition, you’ll enjoy the standard of living in the Indianapolis metro area, with its many amenities, great food and fun family experiences.

• Best for: Balanced cost of living, access to Midwest hospitals, stable demand.
• Average salary: ~$324,205
• Average hourly pay: Indianapolis metro $260-310/hr, 
• Location quotient (metro): 1.7 in the Indianapolis area specifically, rural areas may vary

How We Chose the Best States for Locum Tenens

Curating a list of the top states for locum tenens physicians requires balancing quantitative data with qualitative factors that impact career satisfaction and quality of life. Our method focused on four key pillars:

1. Compensation & Job Market: We analyzed average salaries, hourly wages, and employment data to identify states where locum tenens are competitively compensated. Location quotients helped determine market saturation—whether a state has higher demand (quotient >1) or fewer opportunities (quotient <1) relative to national averages.
2. Hospital Systems & Academic Opportunities: States with nationally ranked medical schools scored higher, as these institutions offer career growth, research opportunities, and cutting-edge practice environments.
3. Quality of Life & Cost of Living: We considered taxes, housing affordability, and lifestyle perks (e.g., outdoor recreation, urban amenities). States with no income tax (Florida) or high salary-to-cost-of-living ratios (Wisconsin, Ohio) gained an edge.
4. Legislation & Practice Environment: Malpractice climates, physician-friendly tort reforms, and state healthcare policies were factored in. 

Salary and employment numbers were critical to our understanding of the state of the job market, but we also incorporated insights from physician recruiters and regional trends (e.g., aging populations in rural areas and competitive metropolitan environments) to ensure our recommendations reflect real-world desirability. The result is a carefully assembled list designed to both reflect current patterns and support you as you make decisions about your locum tenens journey.

Let Us Help You Find Your Next Locum Tenens Role

Looking for a change of pace, better pay, or more flexibility as a surgeon? At Era, we make it easy for skilled surgeons to find top-notch opportunities across the country. 

Whether you're drawn to major academic centers or thriving community hospitals, we’ll help you land roles that align with your goals — with great pay, flexible schedules, and a team that’s with you every step of the way.

Your next practice setting might be closer than you think.