Pennsylvania, like many states, is in a professional liability crisis characterized by escalating cost and decreasing availability of liability insurance. Medical and surgical specialists have experienced especially large increases in insurance premiums. The objective of this study was to estimate the impact of liability concerns during a professional liability crisis on Pennsylvania residents' decisions regarding their future practice.The survey found that the high cost of medical malpractice insurance is a leading reason cited by new doctors for leaving Pennsylvania when their training is finished. More than three-quarters of the medical residents surveyed said they planned to leave Pennsylvania, and almost half of those doctors said the cost of liability insurance was the reason for their departure.