14 Years in USA vs 2 Years in India: A Doctor Reveals the Truth! | Dr. Prerna Kumar

Summary

Dr. Prerna Kumar, a physician specializing in nephrology and kidney transplantation, compares her 14 years of medical training and practice in the United States with her first two years back in India. Her central theme is that both systems have challenges, but she found U.S. hospitals more structured and transparent. She describes significant barriers in India involving professional culture, patient awareness, and accountability.

Career and medical training

• Dr. Kumar says she did not enter medicine with a lifelong ambition to become a doctor. Her family encouraged her toward it, and she grew to love medicine and healing during her training.
• She completed her MBBS in Karnataka, followed by an internship and junior residency at Ram Manohar Lohia Hospital in Delhi.
• For U.S. training, she applied to roughly 200 programs and received five interviews. In her experience, some specialties, such as dermatology and orthopedics, are especially difficult for international applicants to enter, while family medicine, pediatrics, psychiatry, and internal medicine are more accessible.
• She describes U.S. fellowship applications as individual applications followed by interviews and a matching process: applicants and institutions rank one another, and a placement occurs when the rankings align.
• She portrays U.S. teaching as protocol-driven, with regular conferences, formal evaluation, and discussion of research and patient cases. She contrasts this with her experience in India, where junior doctors may spend more time on routine departmental tasks and where she felt teaching and accountability were less consistent.

Work culture, accountability, and respect

• Dr. Kumar recalls supportive colleagues and a welcoming environment during her U.S. residency and fellowships. She says she did not experience the kind of senior-driven harassment or ragging she had heard about in Indian postgraduate training.
• She describes systems intended to protect residents and patients, including work-hour reporting, patient feedback channels, and regular reviews of cases where a patient died or might have been saved. She also says residents sometimes worked very long weeks—up to 100 hours in her experience—and that supervisors encouraged accurate reporting within the system’s limits.
• She emphasizes professional boundaries: when she was not on call, patient calls generally went through a hospital call center rather than directly to her. She contrasts that with the more informal, messaging-based communication she encountered in India.
• In her account, U.S. patients were treated as participants in their care. Doctors were expected to explain treatment and communicate openly, and patients could provide feedback about their care.
• After returning to India, she says she encountered resistance and exclusion in some professional settings. She recounts being told that she would not be able to advance within a close-knit medical group because she had trained in the U.S. She also describes being advised to wear traditional clothing at a hospital, which she felt was at odds with the practical demands of her work.
• She argues that doctors in India work hard but often face a “thankless” environment, and she calls for greater transparency and accountability.

Pay and career opportunities

• Dr. Kumar recalls U.S. residency pay starting at about $62,000 a year and increasing modestly during training. She also describes temporary hospitalist work with one-week-on, one-week-off scheduling and higher pay for some night or holiday shifts.
• For her transplant-nephrology role in Chicago, she says she was offered $200,000 a year as an associate professor. She gives higher figures for senior physicians and some other specialties, while stressing that pay depends on specialty, seniority, institution, and other factors.
• She names dermatology, orthopedics, radiology, cardiology, and possibly urology among higher-paying U.S. specialties, but is uncertain about the exact ranking. She also notes that visa sponsorship can affect international doctors’ opportunities.
• To illustrate the difference she perceived in compensation, the host cites a report of a cardiothoracic surgeon in Himachal Pradesh earning ₹34,000 per month. Dr. Kumar reacts with disbelief and compares it with the much higher pay she had seen in the U.S.
• These figures are personal recollections and examples from the discussion, not a complete or definitive salary survey.

Visa pressures and returning to India

• Dr. Kumar says visa uncertainty affected her sense of security and belonging in the U.S. She describes long waits for visa appointments and says she could not see her parents for four years during the COVID period.
• She recalls feeling valued as a doctor at work but reduced to a visa status or “a number” in immigration processes. She says separation from family and the fear that she might not be able to return after traveling were emotionally difficult.
• She returned to India about two years before the interview. She says her first year back involved visiting hospitals and considering where she could work, but she felt unwelcome in some professional circles.
• Her broader concern is that she may not be able to change the system from within. She says she might consider leaving again if she cannot make meaningful improvements, while acknowledging the efforts of doctors who continue working in difficult conditions.

Kidney transplantation, donation, and patient education

• Dr. Kumar says deceased-donor organs are underused in India and that living donation remains more common. She sees a need to raise awareness about deceased donation and improve the processes around transplantation.
• She argues that patients with declining kidney function should be referred to a nephrologist—and, when appropriate, a transplant nephrologist—early enough to discuss transplantation before dialysis begins. She gives an eGFR below 20 as a point at which referral and transplant planning may be important, presenting this as her explanation of clinical guidance rather than individualized medical advice.
• She says unnecessary blood transfusions in some chronic kidney disease patients can lead to antibody formation, potentially making later donor matching harder. In her view, doctors need better education about how treatment decisions can affect future transplant options.
• She explains that kidney matching involves both blood-group compatibility and tissue matching, including HLA markers. Her practical message to patients is to ask their care team to explain the specific match and mismatches rather than relying on a simplified label such as “six out of six.”
• She raises concerns about opaque transplant processes and alleges that manipulated paperwork and financial arrangements can enable illicit activity. These are her claims and concerns as presented in the interview; they are not independently established by the subtitles.
• She also criticizes assumptions about the cause of kidney failure without adequate investigation. She describes kidney biopsy and discussion with pathology specialists as important tools for identifying the underlying disease, including conditions that may recur after transplant.
• She shares stories of transplant recipients whose lives improved after surgery, explaining that the possibility of patients returning to relationships, travel, work, and other life goals motivated her interest in transplantation.

Filmmaking and overall message

• Dr. Kumar says filmmaking became a way to communicate ideas she could not express through clinical work alone. Inspired in part by medical dramas, she is developing a roughly 45-minute docudrama about kidney transplantation and a short nephrology book intended to help patients and families understand their options.
• Her goal is to make patients better informed so they can ask questions, understand procedures, and be less vulnerable to gaps in the healthcare system.
• In the rapid-fire segment, she says the choice between the U.S. and India depends on what a person wants from life. Her broader message is that medicine involves caring for the patient as a whole person, communicating openly, and treating the patient’s dignity and future as important parts of care.

Speakers and sources featured

• Dr. Prerna Kumar — Physician specializing in nephrology and transplantation; shares her personal experiences and opinions about medical training, practice, visas, and transplant care.
• Dr. Nachiket Bhatia — Host of The Nachiket Bhatia Show; asks the interview questions.
• Channel introduction and closing narration — An unidentified voice introduces the episode and delivers the closing appeal.