By Erica Cerutti

Montana is the best state for physicians to practice in 2026, a recognition it has retained for several consecutive years as part of an annual ranking.

New York, New Jersey and Rhode Island were deemed the worst states to practice, according to the 2026 ranking, published March 17.

All 50 states and the District of Columbia were evaluated across two key dimensions: opportunity and competition, and medical environment. Within those dimensions, 19 metrics are considered, ranging from average annual wage to quality of the public health system and hospital safety grades. Each metric was graded on a 100-point scale, with 100 representing the most favorable conditions for physicians. Each state’s overall score was calculated using the weighted average across all metrics.

15 best states for physicians:

1. Montana

2. Indiana

3. Louisiana

4. South Dakota

5. Minnesota

6. North Dakota

7. Missouri

8. Nebraska

9. Iowa

10. Wisconsin

11. Mississippi

12. Utah

13. Kansas

14. South Carolina

15. Idaho

And the worst:

1. New York

2. New Jersey

3. Rhode Island

4. Hawaii

5. District of Columbia

6. Illinois

7. New Mexico

8. Oregon

9. Maryland

10. Vermont

11. Pennsylvania

12. Connecticut

13. California

14. New Hampshire

15. Massachusetts

Four more insights from the ranking:

- Montana, which ranked No. 1 overall, placed second for opportunity and competition and 15th for medical environment.

- Missouri placed first for opportunity and competition, though ranked 42nd for medical environment. It ranked No. 7 overall.

- Utah ranked first for medical environment, though 31st for opportunity and competition. Overall, it ranked No. 12.

- New York (No. 51 overall) placed 48th for opportunity and rank, and 47th for medical environment.