10 Best States to Work in Radiation Oncology 

Radiation Oncology is doing better than most specialty areas when it comes to the physician shortage. But it’s complicated. While standard factors like population aging, increases in cancer diagnoses and stable-but-low replacement rates are contributing factors, employment and replacement have held stable. 

But there’s another issue on the horizon: practice consolidation. As fewer radiation oncologists enter the field, the number of individual practices has shrunk while large practices grow. Current studies on the state of the field suggest proactive action on consolidation and reimbursement are needed to ensure a stable workforce post-2030.

Despite the complexities of the market, the outlook for RO locums physicians remains as bright as demand is strong. That means lots of opportunities and info – so let’s help you narrow down your search.

In previous blogs we’ve touched on some of the hottest locum tenens specialties like Cardiology, Urology, Surgery and Neurology. 

But today we’re thinking about your career moves as an RO. Should you stick to a practice in a metro area? Move to a rural county for deeper savings? Consider factors like family, climate or travel access?

We did the numbers to help you find the answers you need. 

Let’s dive into the top states for Radiation Oncology.

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 to Work in Radiation Oncology

• Texas
• Florida
• Pennsylvania
• North Carolina
• Arizona
• Ohio
• Georgia
• Michigan
• Minnesota
• Washington

1. Texas

• Average Annual Salary: $279,590
• Average Hourly Pay: $134.42
• IMLC: Compact State
• Location Quotient: 1.9
• Major Radiation Oncology Centers: MD Anderson Cancer Center (Houston), UT Southwestern (Dallas), Baylor College of Medicine (Houston), Texas Oncology (Statewide).

Texas is the state where practice meets innovation. With unparalleled scale and variety, all within a no-income-tax, and a compact-license framework, Texas has a lot to offer physicians.

The Lone Star State has become a premier destination due to the singular presence of MD Anderson, which creates a massive ecosystem for radiation oncology, driving high demand for physician coverage at centers statewide. As a Compact State with no income tax, the financial and logistical efficiency can’t be overstated. You’ll find multiple other NCI-designated centers and the large Texas Oncology network ensures a constant, high volume of opportunities in both metro and regional settings. Major airports in Dallas, Houston, and Austin provide easy access for regular travel.

2. Florida

• Average Annual Salary: $242,840
• Average Hourly Pay: $116.75
• IMLC: Compact State
• Location Quotient: 2.0
• Major Radiation Oncology Centers: Moffitt Cancer Center (Tampa), Mayo Clinic Florida (Jacksonville), Miami Cancer Institute (Baptist Health), AdventHealth Cancer Institute (Orlando).

Florida has grown in popularity with physicians because of its extremely high patient volume, dense concentration of top-tier cancer centers, and lack of a state income tax.

The state’s enormous retiree population directly drives the highest per-capita demand for cancer services in the U.S. This continuous demand coupled with destination cancer centers, creates a competitive market with high locum needs. Being a Compact State with no income tax also makes it highly attractive for physicians who are looking to save their take home pay. While salary data falls more in the middle, locum rates in this high-demand specialty are top-notch. For travel, Florida has multiple international airports (MIA, MCO, FLL, TPA) as a gateway to the U.S. and international destinations.

3. Pennsylvania

• Average Annual Salary: $268,290
• Average Hourly Pay: $128.99
• IMLC: NOT a Compact State
• Location Quotient: 1.7
• Major Radiation Oncology Centers: Hospital of the University of Pennsylvania (Philadelphia), UPMC Hillman Cancer Center (Pittsburgh), Fox Chase Cancer Center (Philadelphia), Penn State Cancer Institute.
• Explore locums jobs in Pennsylvania.

The Keystone State combines academic radiation oncology and proton therapy centers, with high pay. 

For physicians looking to further both academic and clinical practice, Pennsylvania is a cornerstone of academic radiation oncology, home to pioneering programs and multiple proton therapy centers. With concentrated resources for high-level care, you’ll find continuous demand for locums in Pennsylvania. The state also offers strong pay. But physicians should be aware that this is not a Compact State, meaning that licensing will take longer and you should budget for that. But the flat 3.07% income tax rate also remains a reasonable draw for many physicians. Philadelphia (PHL) and Pittsburgh (PIT) are major air hubs, providing good access to assignments across the state's many hospital networks.

4. North Carolina

• Average Annual Salary: $278,690
• Average Hourly Pay: $133.99
• IMLC: Compact State
• Location Quotient: 1.6
• Major Radiation Oncology Centers: Duke Cancer Institute (Durham), UNC Lineberger Comprehensive Cancer Center (Chapel Hill), Wake Forest Baptist Comprehensive Cancer Center (Winston-Salem), Levine Cancer Institute (Charlotte).

The Tar Heel state offers a great mix of academic and clinical opportunities on the East Coast. It’s best known for its dense, collaborative oncology network in the Research Triangle and connection to national healthcare networks via efficient compact licensing.

The Triangle (Raleigh, Durham, Chapel Hill) is one of the nation's most concentrated life sciences and oncology research corridors. With three NCI-designated comprehensive cancer centers within a short drive, the demand for highly skilled radiation oncology locums is consistently high. Physicians are also drawn to the high pay rates in the state, and favorable cost of living and travel options via RDU and CLT. 

5. Arizona

• Average Annual Salary: $268,670
• Average Hourly Pay: $129.17
• IMLC: Compact State
• Location Quotient: 1.7
• Major Radiation Oncology Centers: Mayo Clinic Cancer Center (Phoenix), University of Arizona Cancer Center (Tucson - NCI-Designated), Banner MD Anderson Cancer Center (Gilbert).

If you’re looking for strong demand in a rapidly growing state with a major destination clinic (Mayo) and favorable tax treatment, welcome to Arizona.

Much like Florida, Arizona's growth and retiree demographics create strong demand. That demand has grown as a result of the high specialized care available at the Mayo Clinic, an NCI-designated center and Banner MD Anderson. As a Compact State with no state income tax for non-residents, Arizona is a great choice for physicians looking to save. And in terms of travel options, Phoenix (PHX) Airport is a major Southwest hub with centralized access to destinations across the Southwest and West Coast. The cherry on top? The climate and quality of life are big perks for traveling physicians.

6. Ohio

• Average Annual Salary: $237,780
• Average Hourly Pay: $114.32
• IMLC: Compact State
• Location Quotient: 1.5
• Major Radiation Oncology Centers: Cleveland Clinic, Ohio State University Comprehensive Cancer Center (James Cancer Hospital, Columbus), University Hospitals Seidman Cancer Center (Cleveland), Cincinnati Cancer Center.
• Explore locums jobs in Ohio.

Ohio holds many opportunities across both metropolitan and rural areas.

Often-overlooked, Ohio is a Midwestern powerhouse in healthcare, with several nationally ranked hospital systems (Cleveland Clinic, OSU) operating large cancer centers. This state has a strong and competitive market for radiation oncology services, and it’s a Compact State, which is crucial for tapping into opportunities across Cleveland, Columbus, and Cincinnati. While pay may appear lower, the low cost of living and abundant locum roles make it a strong market for ROs. Major airports in Cleveland, Columbus, Dayton and Akron ensure travel access to major metro areas and for rural populations.

7. Georgia

• Average Annual Salary: $278,770
• Average Hourly Pay: $134.03
• IMLC: Compact State
• Location Quotient: 1.4
• Major Radiation Oncology Centers: Winship Cancer Institute of Emory University (Atlanta - NCI-Designated), Northside Hospital Cancer Institute (Atlanta), Augusta University Georgia Cancer Center.

Georgia is all about growth. This state offers access to a growing Southeastern market anchored by a key academic cancer center, with excellent travel options.

The Winship Cancer Institute at Emory, an NCI-designated comprehensive cancer center that drives the standard of care and demand for specialists, is one of Georgia’s greatest strengths. The Atlanta metro is a major healthcare hub with several large systems. As a Compact State with a major global airport (ATL), it offers great travel access for locums. The state income tax (~5.75%) is a moderate consideration against the strong base pay and fair cost of living.

8. Michigan

• Average Annual Salary: $241,560
• Average Hourly Pay: $116.14
• IMLC: Compact State
• Location Quotient: 1.4
• Major Radiation Oncology Centers: University of Michigan Rogel Cancer Center (Ann Arbor), Henry Ford Cancer Institute (Detroit), Karmanos Cancer Institute (Detroit).

Michigan holds a diverse mix of cutting-edge therapies, academic spaces and high-volume community care, all accessible with a compact license.

With its large, integrated cancer programs and consistent demand, the Great Lakes State is an up-and-comer for many ROs. The University of Michigan and Karmanos are NCI-designated centers, while Henry Ford operates a network covering significant parts of the state. The variety of care available to patients also ensures a high volume of locum opportunities. The flat 4.25% income tax and lower cost of living in much of the state help physicians save more, offsetting the middle-road pay. While perhaps offering fewer airports than the previously mentioned states, Detroit Metro (DTW) is a major hub.

9. Minnesota

• Average Annual Salary: $276,350
• Average Hourly Pay: $132.86
• IMLC: Compact State
• Location Quotient: 1.3
• Major Radiation Oncology Centers: Mayo Clinic Comprehensive Cancer Center (Rochester), University of Minnesota Masonic Cancer Center (Minneapolis - NCI-Designated).

ROs look to Minnesota for integrated oncology care (Mayo Clinic) in a compact state with high pay and a great quality of life.

Minnesota's ranking is heavily influenced by the global destination status of the Mayo Clinic in Rochester, which creates a unique and high-demand locum tenens market. The Twin Cities also host a major NCI-designated center. The total number of opportunities is likely lower than in some of the previously listed states, but the quality of life can’t be beat. For those with travel on the brain, Minneapolis-St. Paul (MSP) is a top-tier airport. 

10. Washington

• Average Annual Salary: $275,900
• Average Hourly Pay: $132.64
• IMLC: Compact Status is Currently in Process
• Location Quotient: 1.3
• Major Radiation Oncology Centers: Fred Hutchinson Cancer Center (Seattle - NCI-Designated), Seattle Cancer Care Alliance, Providence Cancer Institute (Portland-Vancouver area).

Joining a leading research-oriented oncology community in the Pacific Northwest with high pay and no state income tax– Washington is calling you.

The Evergreen State prides itself in the Fred Hutch/Seattle Cancer Care Alliance partnership, a world leader in cancer research and treatment. This creates a high-demand, intellectually stimulating environment for locums. It offers high BLS compensation and no state income tax, a powerful financial combination. Seattle (SEA) is a major airport, so you’ll never find yourself without travel options. 

Washington’s main caveat is that its IMLC status is "in process"— it has enacted the compact but is not yet issuing licenses. This just means you’ll need to budget extra time for licensing and admin paperwork. 

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.

Find Your Next Locum Tenens Role

Your next role—one that offers better pay, true flexibility, and an ideal location—is not just a possibility; it’s our goal to find it. We partner with you to strategically navigate our extensive network of opportunities across the country, and get you the concierge support you deserve. 

Together, we’ll support you on your locums journey to find a role where you thrive.