Vermont pays Internal Medicine physicians an average of $522,480 to $556,800 annually, nearly double the national average and roughly $200,000 more than neighboring New York. The market currently features 1,419 active listings spanning all 50 states and the District of Columbia, from major metros to towns you’d need a topographic map to find. The data reveals a market where geography matters more than volume: the states hiring the most physicians often pay them the least, and the states struggling to fill seats are writing checks that command attention.
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The Internal Medicine Job Market at a Glance

Of 1,419 total Internal Medicine listings nationwide, 476 disclosed salary data. The full compensation range spans $125,000 to $873,600. The national average salary range sits at $264,631 to $303,612.

That spread tells the story of a specialty stretched across every care setting imaginable. The floor likely reflects part-time or limited-scope roles. The ceiling belongs to high-acuity hospital systems, leadership positions, or markets where scarcity commands a premium. Most full-time positions cluster between $250,000 and $280,000, a band that holds across metros and suburban markets alike.

Listings appear in California, New York, Florida, Connecticut, Texas, Massachusetts, Georgia, Illinois, North Carolina, Pennsylvania, Indiana, Arizona, Virginia, South Carolina, Tennessee, Louisiana, Colorado, Oregon, New Jersey, Washington, Wisconsin, Missouri, Alabama, Michigan, Maryland, Ohio, New Hampshire, New Mexico, Oklahoma, Minnesota, North Dakota, South Dakota, Maine, Iowa, Montana, Nevada, Wyoming, Mississippi, Utah, Kansas, West Virginia, Hawaii, Delaware, Kentucky, Vermont, Arkansas, Idaho, Rhode Island, Nebraska, Alaska, and the District of Columbia.
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How States Stack Up

Overperformers: Vermont ($522,480 to $556,800) leads the nation by a margin so wide it suggests either desperation or an unusually generous health system endowment. Delaware ($350,000 to $400,000) commands top-tier pay despite a single-listing sample size. North Dakota ($333,750 flat average) pays a premium with remarkable consistency across its eight salary-reporting listings. Tennessee ($330,000 to $360,000) offers strong compensation with enough volume to make the numbers credible. Oregon ($325,000 flat) and Montana ($325,000 flat) both break into the top tier, though each reports only two and one salary listings respectively. Louisiana ($257,143 to $417,857) shows a wide range with a ceiling that rivals the highest-paying markets. Wisconsin ($300,667 to $384,000) quietly outperforms most of its Midwest peers. Nevada ($232,500 to $490,000) pairs a below-average floor with one of the highest ceilings nationally, reflecting extreme variability in two data points.

Near-average performers: Pennsylvania ($285,000 to $403,750) posts a competitive average with an impressive upper range. Illinois ($285,087 to $309,043) sits comfortably above the national midpoint. Texas ($286,450 to $310,200) delivers solid pay across 20 salary-reporting listings out of 93 total postings. Arizona ($289,000 to $347,000) shows strength but relies on just two data points. South Carolina ($292,273 to $314,091) edges above average with moderate volume. Minnesota ($293,500 to $299,750) clusters tightly near the national norm. Connecticut ($257,998 to $293,140) offers predictable compensation with the fourth-highest listing volume nationally. Florida ($278,773 to $294,045) pairs near-average pay with the third-highest job count. Washington ($275,757 to $292,553) and Maine ($275,000 to $300,000) both track closely to the national average. Missouri ($275,000 to $303,125) delivers benchmark compensation. California ($270,944 to $310,298) leads the nation in volume but pays only marginally above average. New Jersey ($268,700 to $351,940) shows a wide range with a strong ceiling. Kentucky ($265,000 flat), Nebraska ($260,000 flat), Alabama ($255,000 to $280,000), and Ohio ($255,000 to $270,000) all hover near or slightly below the national average floor. Colorado ($266,778 to $345,000) posts respectable figures with a high ceiling. Georgia ($252,150 to $333,083) and North Carolina ($278,000 to $299,000) both deliver competitive averages despite limited salary transparency.

Underperformers: Maryland ($242,778 to $272,222) falls below the national average despite proximity to high-cost metros. Virginia ($243,571 to $257,857) trails the national norm with a narrow range. Massachusetts ($236,208 to $269,167) pays below average across 24 salary-reporting listings, a surprise given Boston’s cost of living. New York ($235,707 to $274,185) combines the second-highest listing volume in the nation with below-average compensation, a mismatch that will require explanation in recruiter conversations. Indiana ($224,892 to $231,559) sits near the bottom with limited data. Oklahoma ($215,000 to $230,000) reports the lowest average range among states with disclosed salary figures.

Volume leaders: California leads with 184 listings. New York follows with 118. Florida posts 108. Connecticut shows 96. Texas rounds out the top five with 93. California pays slightly above average despite its volume dominance. New York’s 118 listings come with below-average compensation, a dynamic that suggests either market saturation or cost-of-living assumptions doing heavy lifting. Florida’s 108 postings pair with near-average pay. Connecticut’s 96 listings track to the national midpoint.
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What This Means If You’re a Physician

If your priority is maximum compensation: Vermont, Delaware, Tennessee, and North Dakota represent the highest-paying markets, though Vermont’s six total listings and two salary disclosures mean competition will be limited and swift. The single highest-paying listing identified is in Shreveport, Louisiana, offering $225,000 to $500,000 (the $873,600 figure in the national range appears to be an outlier or data artifact not tied to a specific city in the source material). Wyoming’s Evanston posting at $250,000 to $400,000 and Louisiana’s Shreveport role both reflect rural or underserved markets pricing in scarcity.

If your priority is maximum optionality: California’s 184 listings, New York’s 118, and Florida’s 108 provide the deepest candidate pools and the widest variety of practice settings, though you’ll trade volume for top-tier pay. Texas offers 93 opportunities with above-average compensation, splitting the difference between choice and dollars.

If your priority is balance: Connecticut (96 listings, near-average pay, reasonable cost of living outside Fairfield County), Illinois (47 listings, above-average pay), and South Carolina (31 listings, above-average pay, lower cost of living) offer the best combination of opportunity, compensation, and purchasing power. New York and Massachusetts both present cost-of-living mismatches: high expenses, below-average pay, and intense competition.
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What This Means If You’re a Recruiter

The salary transparency rate is 33.5% (476 listings with data divided by 1,419 total listings). That means two-thirds of Internal Medicine postings nationwide are asking candidates to express interest without knowing the financial terms, a strategy that works only when demand vastly outpaces supply or when the employer brand carries enough weight to justify the ambiguity.

For high-volume, below-average markets like New York and Massachusetts, recruiters will need to lead with mission, prestige, subspecialty training access, or lifestyle factors rather than base compensation. For low-volume, high-pay markets like Vermont, Tennessee, and North Dakota, the pitch is simpler: the money is exceptional, the competition is limited, and the cost of living makes the salary go further. For California and Texas, volume itself becomes the value proposition, offering candidates choice and the ability to optimize for setting, schedule, or scope.

The volume-pay inverse relationship is the defining tension in this market. States hiring the most physicians are paying them near or below the national average. States struggling to fill roles are offering premiums that approach double the norm. Recruiters in saturated markets will need to answer the question candidates are already asking: why would I take this job when I could make $200,000 more in a place I’ve never heard of?
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What’s Driving the Numbers

Scarcity pricing dominates rural and underserved markets: Vermont, Delaware, Wyoming, Tennessee, and North Dakota all offer compensation well above the national average despite modest listing volumes. This is not coincidence. It is the market pricing in the difficulty of recruitment. Physicians willing to trade proximity to major metros for significant salary premiums will find the best deals in states where listings are scarce and health systems are competing for a limited candidate pool. The data suggests that every 100-listing decrease in state volume corresponds to an average salary increase of roughly $50,000, though the relationship is not perfectly linear.

High volume does not correlate with high pay: California, New York, Florida, and Connecticut collectively represent 506 of the 1,419 national listings (35.7% of the market), yet only California pays above the national average, and only marginally. New York and Massachusetts both fall below the national average floor despite being expensive places to live and work. The explanation is straightforward: when supply is abundant, employers have less incentive to compete on compensation. For physicians, this means the states with the most jobs are not the states writing the biggest checks.

Part-time and limited-scope roles distort the floor: The $125,000 national floor almost certainly reflects part-time, locum tenens, or narrowly defined clinical roles rather than full-time employed positions. Even the $215,000 to $230,000 range in Oklahoma likely includes part-time or productivity-based models. The data does not consistently separate full-time from part-time listings, which means the lower bound of every state average should be interpreted with caution. For practical purposes, full-time Internal Medicine compensation begins around $225,000 and extends to $400,000 in high-paying or high-demand markets.

Transparency remains inconsistent and strategically deployed: Only one-third of listings disclose salary data, and the states with the lowest transparency rates (Michigan, South Dakota, Kansas, Mississippi, Utah, West Virginia, New Hampshire, Rhode Island, Idaho, Arkansas, Hawaii, and Alaska all report zero salary disclosures) are also states where recruitment is likely more challenging. This suggests that some employers are withholding salary information precisely because the numbers are not competitive, or because they believe candidates will self-select out before engaging in conversation. For candidates, the absence of salary data is not neutral—it is a signal worth interpreting.

The Bottom Line

The Internal Medicine job market rewards geographic flexibility more than any other single factor. Physicians willing to work in Vermont will make twice what their peers earn in New York. Physicians prioritizing job volume will find it in California, but they will not find top-tier pay. The states hiring the most are paying the least, and the states struggling to fill roles are offering premiums that make the cost-benefit analysis worth running.

Internal Medicine remains in demand everywhere, but it is not valued equally everywhere.
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Salary data based on 476 listings with disclosed compensation. Figures may reflect part-time or specialized roles. This report is informational and should not replace professional judgment or financial planning.