We are in New England and blessed to have some of the best hospitals and doctors in the world, which is why this new study is perplexing.

According to Wallethub.com, doctors in these states have the most optimistic future based on these specific categories: Opportunity & Competition, and the Medical Environment.

Doctors are one of the highest paid professions in America, but also carry an average of $200,000 in graduate school debt, which takes years to pay off.

There are many factors in considering the best states for M.D.'s to practice, like how many hospitals per capita, how old is the population, the average pay rate for a physician, how fierce the competition, advancement opportunities through continuing education, the number of residents retained, and the cost of malpractice insurance.

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I'll bet you didn't think of all of these factors when you scheduled that annual physical.

The WalletHub survey rated the best and worst states for doctors, and it's shocking to learn that in a state touting some of the best hospitals in the world, Massachusetts has one of the worst ratings for physicians.

Looking closer, consider the competition for M.D.'s in one of the best medical communities in the country.  According to USNews.com, there are 101 hospitals in Massachusetts, with most of them concentrated in the Greater Boston area. This creates more competition for the most coveted positions, which also pay better.

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Medical breakthroughs, an aging population, along with the boom of Physician's Assistants programs, make practicing medicine, paying for eight years or more of higher education, medical school loans, malpractice insurance, and new regulations tougher for doctors to thrive. Also, cost of living increases point to Massachusetts as being one of the more difficult states to prosper as a medical doctor.

Doctors average about $208,000 in income per year, but it doesn't happen right away. The esteemed practice of medicine is now as difficult as any other comparable high-salaried corporate position.

The best state for a physician is Montana.  Massachusetts ranks #48, New Hampshire is #29, and Maine is #31.

The outlook doesn't look better five years down the road either.  It's no wonder there's a physician shortage on the horizon.

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