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Thinking of R2I - Physician

Posted: Sat Nov 26, 2011 12:20 pm
by RR3
Recently started thinking about move to India. - Hyd.


i have been practising here for about 5 1/2yrs now internal medicine. Not sure how opportunities are like - for physicians who R2I.

Thinking of R2I - Physician

Posted: Sun Nov 27, 2011 2:41 am
by Man
RR3;424924Recently started thinking about move to India. - Hyd.


i have been practising here for about 5 1/2yrs now internal medicine. Not sure how opportunities are like - for physicians who R2I.


Welcome to the forum. There is a thread on starting a medical practice in India

http://www.r2iclubforums.com/forums/showthread.php/21112-Starting-a-Medical-Practice-in-India

which you can browse for a lot of useful information of a general nature.
Specific advice to you may be more constructive if you provide a few more details - immigration status family situation, goals of r2i, etc
Assuming you are male and a GC holder and are contemplating a internist practice in Hyd as a general rule it is quite a risky proposition - a internist in India is pretty much a marginally glorified GP and it will be a uphill battle for you to justify your US cutting edge education and Board certification. If you are serious I would advise you to take a couple of years and get a subspecialty training under your belt - its not too late and it can be a short 2 year one - rheumatology and endocrine are two disciplines not too competitive to get into and which can allow you to build a very niche practice in India. There are numerous generic issues with medical practice in India - again the thread on medical practice should cover most of them. There are quite a few docs who are active posters in this forum so you will get good advice - you are in the right place. Best wishes.

Thinking of R2I - Physician

Posted: Sun Nov 27, 2011 6:56 am
by TowardsHome
Man said it all. No other field of medicine has a gulf as wide as internal medicine does between working conditions in United States and India .Just to give you a small example, a hospitalist colleague of mine who is also an MRCP went back recently and was offered 60,0000. If you are the primary bread winner and practice is your predominant source of income it might be an uphill journey. There are two American returned physicians from Hyderabad ,one of them an internist in this forum .They can provide you great insights

Thinking of R2I - Physician

Posted: Sun Nov 27, 2011 7:34 pm
by rajradio
The internist is member CABO. As far my view is concerned it can be hard for internal medicine person to return to India. now that be as it may a slight reorientation of the goals, and redefining the word "oppurtunities" would be helpful.

Personally, there is a definite service gap, in the area where the IM doc, spends a good 30-45 min, with the patient, does a good physical, and looks after all the chronic ailments including HTN, DM, thyroid issues well. Such a clinic concept might fly in high end areas (like jubilee hills, bhills, madhapur, hitech city), and the consultation charge may be high as well ( not less than 600).


Still its less money and more work than US, but atleast 4-5 years down the line, if you are good you ll rise to the very top. Remember there is endless population in India, so if you are even reasonably good, you in effect have infinite supply of patients, just have to reach the inflection point where people think you are good.

Take my own house for example, I hadnt for a few years looked at my dads meds, he goes to a cardiologist to manage his HTN, when I looked at his meds 2 months ago he was on 4 different meds in every concievable drug combinations and yet his HTN was poorly managed. So I found him an american board certified physician, we pay him 2000 rupees per home visit.

some of the greatest opportunities arise from the deepest throes of chaos, and there is not dearth of chaos in India.

But working for corporate hospitals(as internist) in HYD is a bit of a waste of time and resources. and like man said there is also lot of opportunties for fellowship trained MDs as well.

( the above is my view only, just like a little stock tip, you have to do your own due diligence and own research)

RK

Thinking of R2I - Physician

Posted: Sun Nov 27, 2011 9:58 pm
by sumachechi
I would totally go with whart raj has said. THink about setting up a good internist practice- aim upmarket, do the basics well, network with good subspecialists and you will do well. THere is definitely a dearth of good internists in India and doing good work will show itself.
Expecting a defined career pathway may be challenging....

Thinking of R2I - Physician

Posted: Sun Nov 27, 2011 10:50 pm
by drV
I am here in USA so can't give you first-hand account.
From my little research some time back...I can tell you....the "step-down" will be quite steap......as far as quality of work, remuneration and status in the medical community are concerned; no matter what kind of work you do here or plan to do there.

In my case it would have been a slam-dunk big-time professional downgrade.

I found that locum-work few months every year back in USA was much more attractive alternative ; from professional perspective.

All the lengthy possible alternatives aside.....my medicine professor always started his lecture with
"Common out-comes occur commonly, they should be thought commonly, and when asked, should be uttered commonly".

Thinking of R2I - Physician

Posted: Sun Nov 27, 2011 11:13 pm
by sumachechi
[QUOTEFrom my little research some time back...I can tell you....the "step-down" will be quite steap......as far as quality of work and remuneration and status in the medical community are concerned; no matter what kind of work you do here or plan to do there. ]

Quality- no reason why you cant do high quality work in India.
Remuneration- cannot comment. Depends on the way you set up yourself, your marketing etc etc. Attached just to a hospital is probably not the best move for you. And you will have to work hard, but then docs in the US are used to working very hard,in my experience. Europe spoils you in a way with the working time directives.
Status- Hey , that's pretty good.

Would you consider Vizag- a city which badly needs good doctors and plenty of public service companies offering good medical insurance for employees, so people will seek healthcare?

Thinking of R2I - Physician

Posted: Sun Nov 27, 2011 11:15 pm
by RR3
many thanks to man, homebound, raj radio and sumachechi.
just came to know of this site. it is a wonderful community

Thinking of R2I - Physician

Posted: Sun Nov 27, 2011 11:16 pm
by cabo
I may be a bad example and my experiences may not be relevant to you. But, for what its worth- my 2 cents.

It makes absolutely no sense financially for an average Internist to move to India. The only General physician who charges 500 Plus in Hyd, that I know ( maybe tells how little I know) is Dr shantaram - (a star physician and VVS's dad), who is retired from NIMS, holds govt advisory positions, does only out-patient practice now in upmarket srinagar colony. ALso, doing outpatient only practice is not a viable proposition, IMO. To be able to charge higher, you should be attached to a good hospital- to be able to admit and follow your own patients. There are hardly any open Internist consultant slots in any established corporate hospitals in Hyderabad. There are many new multi-speciality hospitals coming up- one could be attached to those for patient admissions.

Having an American Board certification in Internal Medicine is no advantage and hospital administrators know that. Infact, it is a huge dis-advantage in practice- 70-80% of inpatient admissions are Tropical diseases and very seriously ill with them. If you haven't managed them at all - has a steep learning curve. Not having a group practice concept means, you are working longer hours for little money.

Thinking of R2I - Physician

Posted: Sun Nov 27, 2011 11:37 pm
by RR3
Man , thanks for pointing out . a little bit of background.

i am from hyderabad, went to Osmania medical college. until i reached my housemanship little did i think i would embark on this exciting journey.

after my training in IM started my job. it has been satisfying professionally.

my parents are back in India,
I am blessed with a understanding spouse. a soon to be 3yr old busybody.

work - is great from professional and financial perspective
but get the feeling it is time to start planning for the move