HONOLULU (KHON2) -- Although Hawaiʻi is often celebrated for its beautiful beaches and serene landscapes, our state is facing a growing challenge in the medical field. In a new report, Hawaiʻi was ranked 51st out of all 50 states and the District of Columbia. That means Hawaiʻi is the worst st ate for physicians to practice, according to the study. The state struggles with issues that directly affect healthcare quality that include low physician salaries, high malpractice payout amounts and a severe doctor shortage. A tough financial environment for physicians According to the rankings, Hawaiʻi is one of the worst states for physician salaries, especially when adjusted for the cost of living. Additionally, Hawaiʻi has some of the highest malpractice payout amounts per capita in the nation, which increases financial risk for doctors. While malpractice insurance costs are high, they are not the absolute highest in the country—states like New York and Illinois rank worse in that regard. Furthermore, Hawaiʻi faces a physician shortage, particularly in primary care and rural health. Although Hawaiʻi is not the absolute worst state for physicians per capita, the shortage is significant and continues to grow. Training the next generation of physicians: JABSOM’s Role Despite these challenges, the University of Hawai‘i John A. Burns School of Medicine (JABSOM) is working to address the physician shortage. JABSOM focuses on training local students who are committed to staying in Hawaiʻi to care for its communities. While 41% of JABSOM’s Class of 2025 will complete their residencies in Hawaiʻi, there has been a 10% increase from 2024. Get Hawaii's latest morning news delivered to your inbox, sign up for News 2 You Additionally, JABSOM indicated that 66% of the Class of 2025 will enter primary care specialties such as Internal Medicine, Pediatrics, Family Medicine, and OB-GYN. These are all fields in high demand across the islands. "Being able to stay home and train with the population that I'm going to work with in the future was really important to me," said Awapuhi Lee, a JABSOM student who matched with a psychiatry residency program in Hawaiʻi. This deep connection to the community is central to JABSOM’s mission to train and retain local doctors. Serving Hawaiʻi’s rural communities One of the greatest challenges in Hawaiʻi’s healthcare system is access to medical care in rural areas, particularly on the neighbor islands. Many JABSOM students, like Amanda Tsuhako, are committed to working in these underserved communities. "Six of us were sent [to Lānaʻi] with the Rural Health Medicine Group, and working with the community and seeing how much they band together to overcome the limited access to healthcare really inspired me," said Tsuhako, who is pursuing a residency in family medicine. By focusing on primary care and rural health, JABSOM is not just training doctors. It’s encouraging them to stay and serve the communities where they are needed most. Hawaiʻi’s bright future: Can JABSOM lead the way? While Hawaiʻi currently ranks as the worst state for physicians, JABSOM’s efforts show promise. The school’s mission to train and retain local physicians is slowly improving the state’s medical landscape. Many JABSOM students, such as Nathan Kim, who is entering an Orthopaedic Surgery residency, are determined to serve Hawaiʻi’s residents. "Being born and raised here, I went to undergrad here, medical school here, and now I get to do residency here. I know I want to serve the people of Hawai‘i," Kim said. Hawaiʻi’s healthcare future depends on investing, supporting and retaining locals who want to practice medicine. Get news on the go with KHON 2GO, KHON's morning podcast, every morning at 8 If the state continues to invest in medical education and address systemic challenges, it may eventually transform from the worst state for doctors to a place where more medical professionals choose to live and work. ...read more read less