Great news! The demand for dermatologists is projected to grow, which means you have a lot of job opportunities across the United States from which to choose. Determining where to setup practice is one of the most exciting (and difficult) career decisions a dermatologist will make.
However, there’s one caveat to all the excitement. According to a 2024 study in the Archives of Dermatological Research, projections show a surplus of dermatologists in metropolitan areas and a paucity of dermatologists to meet demand in non-metropolitan areas.
So before you start making plans to work in Manhattan, keep a few things in mind when choosing where to practice:
It’s all about location.
Whether you are looking to start a practice or change employers, it’s important to consider two main categories of locations — urban and rural. Many recent dermatology graduates have their hearts set on the bright lights of the big cities, and there are certainly opportunities for work there. There are benefits and challenges to working as a dermatologist in both urban and rural environments, and it’s up to you to decide your priorities.
Let’s take New York City, for example. Not only do dermatology graduates from across the country move to the Big Apple each year to set up shop or secure jobs at one of the many practices, but there is also competition from within. Many trainees who graduate from one of the New York City programs want to stay in the area. New York City is saturated with dermatologists. It’s not impossible to start a practice there, but it’s certainly a lot more challenging.
On the other hand, let’s take a look at a rural town in California, ranked #1 in states with the worst primary care physician shortages. You may be surprised to see California tops the list, but about one-third of California residents experience a physician shortage. Now, if you did your homework and found a small town with no dermatologist practicing, chances are the residents would throw you a parade and possibly offer a signing bonus, if you were to setup shop there. However, California is the third largest state in the U.S. by land area, so your new home may be a several-hour drive from high-end shopping or a major airport.
As you can see, urban and rural locations each have their merits. Big cities come preloaded with ample patients, diverse opportunities and all the services that make life easy, so it is no surprise that most dermatologists are looking to practice in metropolitan areas. However, small towns offer a slower pace, wide open spaces and unique lifestyle opportunities. New dermatologists might find more success in areas where there is less competition.
Either way, you are going to have to choose which location type is for you, and once you have made the decision, it is time to investigate.
Do your research.
Once you’ve decided the type of location you want, it’s important to do your research. You can use demographical statistics to determine if a location is the right one for you, including average salaries, taxes and licensing rules, as well the lifestyle benefits of the location. While dermatologists used to have to turn to the trusty Places Rated Almanac, all the information is now available online. (AI can be your helper, too!)
Of all the factors to consider, two major items are salary and lifestyle.
Salaries differ based on location.
Salary is one of the first questions that a dermatologist asks when looking for a position on the Dermatology Authority Job Board. We always encourage practices to include salary in job postings. Unfortunately, many times the enthusiasm about practicing in a specific location outpaces the salary. Some of the most popular locations often have the lowest salary due to a larger supply of dermatologists. Here are some states to keep in mind when considering salary:
The 5 states with the lowest physician salary, adjusted for cost of living are:
- District of Columbia and Rhode Island (tied)
- North Dakota
- Massachusetts
- New York
The 5 states with the highest salary, adjusted for cost of living are:
- Nevada
- Louisiana
- Mississippi
- Alaska
- Alabama1
Surprised? States that may not be on your radar may benefit you more financially.
Lifestyle factors impact quality of life.
Where to live is a personal lifestyle choice. Everyone has different preferences regarding climate, recreation and personal interests. While some people would prefer to live on or near the beach, others seek cool mountain air. We all can identify with the need to find a location that provides fun, relaxation and entertainment.
The most popular places to practice usually include ample amenities and services in the area. Theatres, golf courses, sports and fitness facilities, fine dining and natural attractions have almost nothing to do with an actual dermatology practice, but they are large components of what people are looking for in a location. And, while California and Florida rate among the highest in the “most fun” category, tax considerations, salary and other aspects may dim some of that sunshine.
Location benefits for dermatologists looking for a specific lifestyle will be balanced with the salary and opportunities available. So, if salary is the most important consideration, some lifestyle and location preferences may have to go by the wayside. In the same way, if certain considerations are non-negotiable, such as not being able to move out of state for family reasons, salary and lifestyle options will not be as flexible. Knowing these attributes, as well as the challenges and benefits of practicing in each state, gives physicians a roadmap for the development of their professional practice.
Rank your priorities.
My suggestion would be to make a list of what you’re looking for in a practice location, such as proximity to family, salary and climate. Then rank the priorities. Together these factors are your ideal location. While your ideal location may not exist in real life, there may be a few areas that come pretty close. You can create a shortlist with the cities that come closest to your ideal location.
We have complied data below to help you make your list, so don’t fret. Once you know the general area where you would like to settle, remember that the best jobs are not advertised. As dermatologist Dr. Brett Coldiron noted in an article for Dermatology News, “contact all the dermatology, multispecialty, and hospital groups in the area (yes, write them a nice snail mail letter) indicating you are interested, and ask them if they are hiring.”
Above all, enjoy the process! It is your opportunity to get everything you want for you and for your practice. Happy Hunting!
Summary of Benefits and Challenges for Dermatologists, Per State:
Alabama
Salary Range:2
Hourly: $164.17 average
Annually: $341,481 average
Individual Income Tax:3 2-5%
Corporate Income Tax: 6.5%
Benefits: Mild weather, affordable housing, diverse geography and attractions, southern food.
Challenges:4 Ranks in the bottom ten states for pre-K-12 public education; greater than average percentage of residents without health insurance.
Alaska
Salary Range:
Hourly: $195.07
Annually: $405,738
Individual Income Tax: 0%
Benefits: No personal income tax, ample wilderness and recreational opportunities.
Challenges: Remote northern location means a smaller client base; high violent crime rate. Ranks 49th for economic growth.
Arizona
Salary Range:
Hourly: $168.79
Annual: $351,088
Individual Income Tax: 2.59-4.5%
Corporate Income Tax: 4.9%
Benefits: Temperate climate with ample recreational opportunities. Has a high population with a demand for skin care. Ranks sixth in economic growth and third in health care quality.
Challenges: Hot summers and poor air quality. Ranks one of the worst states for pre-K-12 education.
Arkansas
Salary Range:
Hourly: $149.78
Annual: $311,536
Individual Income Tax: 2-3.9%
Corporate Income Tax: 1-4.3%
Benefits: Low cost of doing business, lots of history, culture, architecture and the Ozark mountains.
Challenges: High violent crime rate and unemployment; Ranks 49th in public health.
California
Salary Range:
Hourly: $178.76
Annual: $371,816
Individual Income Tax: 1.1-13.3%
Corporate Income Tax: 8.84%
Benefits: Mild climate, lots of sun, west coast lifestyle and large population concerned about skin health.
Challenges: High cost of living, air pollution in major cities and high unemployment.
Colorado
Salary Range:
Hourly: $190.46
Annual: $396,158
Individual Income Tax: 4.55%
Corporate Income Tax: 4.55%
Benefits: Ranks fourth for business environment, employment and health care quality. Mountain landscapes offer ample outdoor recreational opportunities.
Challenges: High altitude and cost of living. Ranks 48th in public safety.
Connecticut
Salary Range:
Hourly: $172.31
Annual: $358,396
Individual Income Tax: 3-6.99%
Corporate Income Tax: 7.5%
Benefits: Known for autumn scenery, lots of coastline and seafood. Offers rich history right in the heart of the east coast. Access to high-quality higher education.
Challenges: Most of the coastline is private land and there is a high cost of living.
Delaware
Salary Range:
Hourly: $181.29
Annual: $377,074
Individual Income Tax: 0-6.6%
Corporate Income Tax: 8.7%
Benefits: Central location with New York City and Washington, D.C., in close proximity. State is pro-business with tax incentives and laws that favor corporations.
Challenges: Lower ranking public education, high pollution and a small geographic area.
Florida
Salary Range:
Hourly: $135.36
Annual: $281,542
Individual Income Tax: 0%
Corporate Income Tax: 4.458%
Benefits: Stunning beaches and beautiful climate. Although it is more expensive to live and work here, there is a larger client base. Being the sunshine state, Florida needs dermatologists.
Challenges: Ranks lower in affordability and economic opportunity; risk of hurricanes.
Georgia
Salary Range:
Hourly: $152.94
Annual: $318,121
Individual Income Tax: 1-5.75%
Corporate Income Tax: 5.75%
Benefits: Plenty of southern hospitality and southern food. Good balance of rural and urban locations. Access to the world’s busiest airport in Atlanta.
Challenges: Heavy traffic and poor public transportation in Atlanta, sudden weather changes and lots of pollen.
Hawaii
Salary Range:
Hourly: $188.19
Annual: $391,427
Individual Income Tax: 1.4-11%
Corporate Income Tax: 4.40-6.40%
Benefits: Exotic, tropical lifestyle; sun, surf and fresh cuisine. Low violent crime rate. Ninety-five percent of Hawaii residents have health insurance.
Challenges: Has a high homeless rate along with a high cost of living. Ranks in the bottom ten states for business environment and economic growth.
Idaho
Salary Range:
Hourly: $170.42
Annual: $354,482
Individual Income Tax: 1.125-6.925%
Corporate Income Tax: 6.925%
Benefits: Ranks first in the nation for economic growth. Offers numerous outdoor opportunities, including fishing, hunting and rafting at its many parks and recreational areas.
Challenges: Ranks low in water quality and equality.
Illinois
Salary Range:
Hourly: $175.52
Annual: $365,079
Individual Income Tax: 4.95%
Corporate Income Tax: 9.5%
Benefits: Culture, history, urban luxury, four distinct seasons and high-quality schools.
Challenges: Urban sprawl with high property taxes; ranks low for economic growth.
Indiana
Salary Range:
Hourly: $172.36
Annual: $358,501
Individual Income Tax: 3.23%
Corporate Income Tax: 5.25%
Benefits: Access to the Indy 500, low taxes and well-maintained roads. Lower than average violent crime rate.
Challenges: Ranks the worst for pollution, and low in health care quality and public health.
Iowa
Salary Range:
Hourly: $170.13
Annual: $353,868
Individual Income Tax: 0.33-8.53%
Corporate Income Tax: 5.5-9.8%
Benefits: Ranks in the top ten states for affordability and higher education.
Challenges: Predominantly rural population with smaller cities; cold and snowy winters.
Kansas
Salary Range:
Hourly: $161.54
Annual: $336,004
Individual Income Tax: 3.1-5.7%
Corporate Income Tax: 4-7%
Benefits: Well-maintained roads, ample infrastructure and low cost of living.
Challenges: Lack of outdoor recreation opportunities, sparse and remote geography. Ranks low in health care quality.
Kentucky
Salary Range:
Hourly: $157.32
Annual: $327,217
Individual Income Tax: 5%
Corporate Income Tax: 5%
Benefits: Low cost of doing business, affordable housing, rich history and culture, the Bourbon Trail and horses. Low crime rate.
Challenges: High unemployment with a mostly rural population.
Louisiana
Salary Range:
Hourly: $154.89
Annual: $322,168
Individual Income Tax: 1.85-4.25%
Corporate Income Tax: 4-8%
Benefits: Amazing food, culture and music; low cost of living. Also well-known for biking and outdoor sports opportunities.
Challenges: High poverty, violent crime and unemployment rates; rated one of the worst states for business based on the economy. Risk of destructive hurricanes.
Maine
Salary Range:
Hourly: $175.37
Annual: $364,768
Individual Income Tax: 5.8-7.15%
Corporate Income Tax: 3.5-8.93%
Benefits: Stunning sunrises and landscapes with fresh seafood. Ranks second in public safety and equality.
Challenges: One of the bottom ten states to do business in based on business environment and employment. Also in the bottom ten states for transportation.
Maryland
Salary Range:
Hourly: $175.79
Annual: $365,650
Individual Income Tax: 2-5.75%
Corporate Income Tax: 8.25%
Benefits: High household income with delicious crabs, incredible marine life, and lots of attractions and activities.
Challenges: Dense population, high cost of living and high cost of doing business.
Massachusetts
Salary Range:
Hourly: $197.82
Annual: $411,457
Individual Income Tax: 5-9%
Corporate Income Tax: 8%
Benefits: Ranks the top state in business environment and pre-K-12 education with a 90% high school graduation rate. Offers many historical destinations with a luxury east coast lifestyle.
Challenges: Ranks low in affordability; cold winters with high energy costs.
Michigan
Salary Range:
Hourly: $157.87
Annual: $328,373
Individual Income Tax: 4.25%
Corporate Income Tax: 6%
Benefits: Great lakes, car capital of the world, lots of history and natural beauty. Low cost of living with higher than average job growth.
Challenges: Cold winters and unpredictable weather; higher than average violent crime rate.
Minnesota
Salary Range:
Hourly: $177.40
Annual: $368,993
Individual Income Tax: 5.35-9.85%
Corporate Income Tax: 9.8%
Benefits: One of the top 5 states for economic opportunity; home to Mayo Clinic and more than 11,500 lakes. Ranks high for air and water quality
Challenges: Frigid winter conditions; ranks in the bottom half of states for equality.
Mississippi
Salary Range:
Hourly: $171.54
Annual: $356,807
Individual Income Tax: 3-5%
Corporate Income Tax: 3-5%
Benefits: Birthplace of the Blues; incredible music, food and culture. Offers affordable housing and low cost of living.
Challenges: One of the bottom five states for doing business based on business environment, employment and growth. One of the worst states for health care with a high poverty rate.
Missouri
Salary Range:
Hourly: $169.90
Annual: $353,392
Individual Income Tax: 1.5-5.4%
Corporate Income Tax: 4%
Benefits: Incredible caves, and parks and recreational areas. An affordable real estate market with a low cost of doing business. Fiscally stable state government.
Challenges: Risk of flooding and a high violent crime rate.
Montana
Salary Range:
Hourly: $166.25
Annual: $345,798
Individual Income Tax: 1-6.9%
Corporate Income Tax: 6.75%
Benefits: Four season outdoor activities with open spaces; low unemployment and high economic growth.
Challenges: Ranks low for internet access and water quality. Sparse population and harsh winters.
Nebraska
Salary Range:
Hourly: $172.70
Annual: $359,211
Individual Income Tax: 2.46-6.84%
Corporate Income Tax: 5.58-7.81%
Benefits: Low unemployment rate with a fiscally stable state government; high rankings for energy, internet access and transportation.
Challenges: Ranks low for equality and business environment.
Nevada
Salary Range:
Hourly: $184.45
Annual: $383,646
Individual Income Tax: 0%
Corporate Income Tax: Gross Receipts Tax
Benefits: Strong economy and infrastructure, Las Vegas, lots of sunshine and no personal income tax.
Challenges: Poorly rated pre-K-12 education, high violent crime rate and poor air quality.
New Hampshire
Salary Range:
Hourly: $176.15
Annual: $366,392
Individual Income Tax: 0%
Corporate Income Tax: 7.70%
Benefits: Ranked the top state in the country for public safety and economic opportunity. The state is known for its natural beauty with valleys, rivers, lakes and mountains as well as 13 miles of Atlantic Ocean coastline.
Challenges: The state’s fiscal stability; affordability.
New Jersey
Salary Range:
Hourly: $183.89
Annual: $382,489
Individual Income Tax: 1.4-10.75%
Corporate Income Tax: 6.5-11.5%
Benefits: High-quality pre-K-12 public education, low crime rate and access to stunning beaches. Offers world-class universities with a location that’s central to all east coast destinations.
Challenges: Ranks 48th in affordability and is in the bottom five states for fiscal stability.
New Mexico
Salary Range:
Hourly: $175.53
Annual: $365,098
Individual Income Tax: 1.7-5.9%
Corporate Income Tax: 4.8-5.9%
Benefits: Affordable housing and utilities, stunning canyons and valleys, and unique culture.
Challenges: One of the bottom ten states for doing business based on economic factors; high violent crime rate.
New York
Salary Range:
Hourly: $198.16
Annual: $412,176
Individual Income Tax: 4-8.82%
Corporate Income Tax: 6.5%
Benefits: High-quality pre-K-12 public education with beautiful wildlife and coastline. Access to many recreational activities as well as historical and cultural experiences.
Challenges: Long commute, high cost of living and lack of affordable housing in New York City. State has a high unemployment rate and ranks low for economic growth.
North Carolina
Salary Range:
Hourly: $164.61
Annual: $342,391
Individual Income Tax: 5.25%
Corporate Income Tax: 2.5%
Benefits: In the top ten states for economic growth; home to several pharmaceutical companies. Offers lots of history, architecture and coastline.
Challenges: High crime rate, hot summers and hurricane season.
North Dakota
Salary Range:
Hourly: $191.65
Annual: $398,631
Individual Income Tax: 1.1-2.9%
Corporate Income Tax: 1.41-4.31%
Benefits: Low unemployment with a low cost of living. Fresh air and open prairie, and quality infrastructure.
Challenges: Ranks dead last in health care quality and in the bottom five for business environment and economic growth. Sparse population and long, cold winters.
Ohio
Salary Range:
Hourly: $172.20
Annual: $358,174
Individual Income Tax: 2.85-4.797%
Corporate Income Tax: Gross Receipts Tax
Benefits: High-quality pre-K-12 public schools and low cost of living with ample parks and recreation.
Challenges: High pollution and cold, snowy winters. Northern Ohio has lake-effect snow.
Oklahoma
Salary Range:
Hourly: $167.24
Annual: $347,866
Individual Income Tax: 0.5-5%
Corporate Income Tax: 6%
Benefits: Higher than average job growth; affordable housing with a low cost of living and open space.
Challenges: Ranks 49th in pre-K-12 public education; ranks in the bottom five states for health care.
Oregon
Salary Range:
Hourly: $191.51
Annual: $398,331
Individual Income Tax: 4.75-9.9%
Corporate Income Tax: 6.6-7.6%
Benefits: Beautiful west coast rainforest with stunning mountains offers ample outdoor opportunities. Well-maintained roads with no sales tax.
Challenges: Ranks low in pre-K-12 public education and has high personal income taxes.
Pennsylvania
Salary Range:
Hourly: $181.56
Annual: $377,654
Individual Income Tax: 3.07%
Corporate Income Tax: 9.99%
Benefits: Lower cost of living compared with nearby east coast states. Ranks high for health care access and quality. Rich history with lots of options for hiking and other outdoor activities.
Challenges: Low economic growth, high gas tax rate, poorly maintained roads and many rural locations.
Rhode Island
Salary Range:
Hourly: $177.38
Annual: $368,955
Individual Income Tax: 3.75-5.99%
Corporate Income Tax: 7%
Benefits: Beautiful scenery, local food, culture and history with old architecture and mansions. Easy to get from place to place. Ranks high in public safety, business environment and health care.
Challenges: Ranks low in state fiscal stability and last in transportation as more than one third of its roads are in poor condition.
South Carolina
Salary Range:
Hourly: $168.08
Annual: $349,606
Individual Income Tax: 0-7%
Corporate Income Tax: 5%
Benefits: Delicious food, southern hospitality, mild weather, low property taxes with ample cultural and recreational activities.
Challenges: Higher than average violent crime rate. Ranks in the bottom ten states for pre-K-12 public education.
South Dakota
Salary Range:
Hourly: $181.13
Annual: $376,749
Individual Income Tax: 0%
Corporate Income Tax: 0%
Benefits: Low unemployment with a low cost of living. Much shorter commutes than the national average.
Challenges: Has a sparse population and cold winters. Ranks 49th in health care quality and 50th in equality.
Tennessee
Salary Range:
Hourly: $164.40
Annual: $341,944
Individual Income Tax: 0%
Corporate Income Tax: 6.5%
Benefits: The heartland of country music provides ample cultural, historical and recreational opportunities. Ranks fourth in economic growth with no personal income tax.
Challenges: Hot summers with severe weather. One of the worst states for public health with a high crime rate.
Texas
Salary Range:
Hourly: $168.75
Annual: $351,000
Individual Income Tax: 0%
Corporate Income Tax: Gross Receipts Tax
Benefits: One of the best states for doing business based on employment and economic growth. Offers a mix of rural and urban settings as well as a variety of landscapes.
Challenges: Hot summers, high crime rates and low health insurance coverage.
Utah
Salary Range:
Hourly: $164.90
Annual: $342,982
Individual Income Tax: 4.85%
Corporate Income Tax: 4.95%
Benefits: The top state for employment with a favorable business environment; proximity to high-quality skiing and the Sundance Film Festival.
Challenges: High levels of air pollution and a low ranking for equality.
Vermont
Salary Range:
Hourly: $192.59
Annual: $400,580
Individual Income Tax: 3.35-8.75%
Corporate Income Tax: 6-8.5%
Benefits: Ranks the top state for equality and pollution, and the fifth state for employment. Has incredible scenery; known worldwide for its autumn foliage.
Challenges: Ranks low for health care quality.
Virginia
Salary Range:
Hourly: $179.58
Annual: $373,518
Individual Income Tax: 2-5.75%
Corporate Income Tax: 6%
Benefits: Ranks in the top ten for employment and second in the nation in air and water quality. Offers lots of historical, cultural and recreational activities with beautiful beaches and mountains.
Challenges: High cost of living and bad traffic in the areas surrounding Washington, D.C.
Washington
Salary Range:
Hourly: $205.15
Annual: $426,705
Individual Income Tax: 0%
Corporate Income Tax: Gross Receipts Tax
Benefits: Ranks in the top ten for business environment and is the third best state for higher education. Has a strong health care system. Outdoor opportunities abound with a varied landscape that includes mountains, deserts, rainforests and coastline.
Challenges: Has a high cost of living, rains often and ranks poorly in public safety.
West Virginia
Salary Range:
Hourly: $140.22
Annual: $291,668
Individual Income Tax: 3-6.5%
Corporate Income Tax: 6.5%
Benefits: Mountain biking and outdoor adventures, waterfalls and incredible scenery; low cost of living and affordable housing.
Challenges: High unemployment rate, and loss of many industry jobs (steel, manufacturing) causing economic concern. One of the bottom three states for business environment and economic growth.
Wisconsin
Salary Range:
Hourly: $182.82
Annual: $380,273
Individual Income Tax: 3.54-7.65%
Corporate Income Tax: 7.9%
Benefits: Delicious dairy, award-winning cheese, farmers’ markets, lots of festivals and events, and high-quality pre-K-12 public education.
Challenges: Long winters, cold temperatures and lower economic growth.
Wyoming
Salary Range:
Hourly: $174.11
Annual: $362,139
Individual Income Tax: 0%
Corporate Income Tax: 0%
Benefits: Offers rodeos and all things western with wide open spaces; ranks in the top 10 for equality.
Challenges: Low population, mostly rural with a high suicide rate.
[1] https://wallethub.com/edu/best-and-worst-states-for-doctors/11376/
[2] https://www.ziprecruiter.com/Salaries/What-Is-the-Average-Dermatologist-Salary-by-State
[3] https://en.wikipedia.org/wiki/State_income_tax
[4] https://www.cnbc.com/2019/07/10/americas-top-states-for-business-2019.html
