Everyone has their own definition of “too desolate to actually live” … what is your’s?
You need to decide how to balance (1) the quality of the residency vs. (2) the job prospects and local salary rates vs. (3) the state’s quality of life.
Looking only at the quality of life aspects, and as someone who doesn’t mind snow but does mind three digit heat indexes, I like Washington, Oregon, Idaho, western Montana, and Michigan’s UP. WA and OR have rather liberal state politics and might be poor bets for long term considering firearms laws, income taxes, general restrictions on freedom, etc. ID and MT would be much better for that and MI is also a lot better, though not quite ID. Maine might also be worth a look but I don’t know much about it.
I can’t offer any help on the quality of residencies or directly on job prospects. I would consider a state’s current rate of insured state residents (vs. totally uninsured or Medicaid) as a suggestion of how the reimbursement climate might be 5 or 10 years from now.
Anesthesia is also a moderately expensive field for professional liability insurance, so I would avoid the worst states from a PL insurance perspective, which are probably Florida, Illinois, and Pennsylvania. States with a relatively nice liability environment (from a doctor’s perspective) would include Indiana, Wisconsin, Michigan (to a somewhat lesser extent), and the plains states.
I am a big fan of VA and believe I would like NC quite a bit too. NoVA does get lots of filth from DC but depending where you live, you can get to the mountains or the ocean in either. And they have the big cities if you need a dose of that every now and then. Plus, I really like having seasons. I’ve moved around quite a bit so far and while some parts of season suck, its nice to have that variety.
VA has all that. From Richmond. Several rivers in 20 minutes to 1.5hrs. Beach in 2 to 4 hrs depending on which one. Mountains in 1 to 2 hrs. You should be used to the humidity. Minimal snow and rarely days that get to single digits in winter. OC, CCW, NFA … leans heavily red outside the cities. We have recently turned light blue mostly thanks to NoVA which most don’t count as real VA. There is NoVA ( Northern VA ) and RoVA… ( rest of VA ).
Funny you should mention anesthesia. I went in this guys house one day. We have VCU/MCV (Medical College / Trauma Center ) but the campus is in a residential area. It’s just a big mix of row houses, restaurants, campus and short trip to hospital and central business district. You get quite a mix there. So I go in and this was probably 400-500K home, I can’t remember. Pool table, guitars, beer cans everywhere, it looked like a frat party at mid day on a week day. No people just the left overs. So I figure the guy was in a band or maybe an art teacher or something. I asked him what he did. Anesthesiologist… ever since then I always checked to see who was putting me under. So far it’s been women so I figured I was somewhat safe.
Arizona is a good choice as someone mentioned and it seems like we have a lot of medical stuff here. Once you escape Phoenix there are great places like Prescott, Flagstaff, and Sedona. We have an F rating from the anti-gunners, low population density, and decent cost of living.
Not to offend any Wyoming residents, but as someone who has spent significant time in Wyoming, I can’t imagine recommending it as a place to live unless you have an unbelievable tolerance for God awful weather. If you enjoy bitter cold and consider 40 mph wind a “mild breeze”, then you may like it. The people there are great, but I’d take Montana or Idaho ten ways to Sunday.
I loved Alaska when I’ve visited. That being said, I heard there’s a plague of mosquitoes in the summer and -20 to -40*F winters.
I was in the Flagstaff and Sedona area last month, what an amazing place. Beautiful scenery, great gun laws (state-wide of course), and a very decent cost of living. Plus there are quite a few nice outdoorsy things to do like tons of mountain climbing, the Grand Canyon, Colorado River, stuff like that. And it isn’t anywhere near as hot as you’d think when you hear the word “Arizona.” Plus you’re relatively close to Las Vegas 
Idaho.
If you can stand religious ‘cliques’, Utah.
Nevada, anywhere EXCEPT Las Vegas, all of Clark County actually. The Nortwestern area would be right up your alley.
Anesthesiology is the specialty in which you find doctors with the most substance abuse.
The specialties listed are the most competitive, and unless your Step 1/2 scores are up there, and you interview well, your selection will be limited. That said, I would take a hard look at VA for all the reasons already mentioned.
OP, go west young man. Washington has what you’re looking for. The West side is pretty liberal but this whole state is gorgeous.
Avoid the west coast not only for the progressive cess-pool it is, but for the fact that its past overdue for a mega-quake.
I concur.
The only pitfall is that New Mexico doesn’t recognize “self defense” so much as “justifiable homicide.” The practical reality is that if you punch somebody’s time clock you had better be able to convince a jury that you were in reasonable fear of your life.
Other than that, we have two seasons: green and brown
It’s not unusual for some winter days to be warm enough that you only need a light jacket (at least in the Southern portion of the state).
Yes, we do get snow down here, but rarely does it happen more than one or two days a year and it usually melts in a day or so.
People remark that the food in this area (the southern portion from the bootheel to El Paso, Texas) has some of the best, spiciest, Mexican-style food on the planet.
It’s uncanny that whenever I travel around the country and run into someone from New Mexico, the first thing they say they miss is the food.
You have deserts, lakes, and forests all within driving distance.
The only caveat is that you better like hot weather. It’s not as hot as Arizona, but we have more humidity, I think.
The other bad thing is that we pay for our lack of snow with dust storms (local terminology; they are really sand storms).
In March, it can look like a sandstorm in the Middle East.
The Republic of Texas.
Eastern, or Northern Washington, or North Idaho would be great choices. Western Montana as well…
My wife just started her reidency in Washington. I have heard that the anesthesia residencies on cherry hill and pill hill in Seattle are really good, but are very competitive. Those are both in Swattle. We are NFA friendly, but some things are really dumb like universal background checks and firearm transfer tax (sales tax on all gun transfers, even those purchased out of state). We have a ton of hiking, fishing, shooting, camping, river floating, whatever within hours of DT seattle. I am trying to evacuate this state however when her residency is done and I want to go to Alaska.
Lol, working opportunity for the young doctor.
The quality of training and prestige of the program’s need to be your main focus in selecting residency programs for interviews. The specialty is also important, as the more competitive the specialty the less apt you are to “choose” where you are going to train. With that said, I did my residency in Head and Neck Surgery and wrote off applying to any programs in states that disallowed machinegun ownership. But truly your focus must be on matching at the BEST program for your specialty. Training at a top tier program opens doors for top tier fellowship after residency and better employment options. Feel free to email me off the boards if you want to talk more about this. I think you should still have my email.
You’re also not going to have much free time as a resident. Figure out where you want to live after you finish training.
I’ve settled on FL for my move.
If you want mountains, I’d opt for Colorado or montana. Beautiful country scenery. I’d love to visit both, but not my taste to live.