Hi guys,

I am researching the possibilities of returning home from US as an interventional cardiologist in 2023. I know it is still early at this point but due to my visa restriction I have to make up my mind by early 2022, otherwise I will have to start looking for a J1 visa waiver job in the US early next year.

I have a couple questions here, and I appreciate any input from you guys.

1) Do I need to serve the government upon returning home? Or can I go to private directly? I was born and raised in Malaysia, went to India for medical school, followed by internal medicine residency and cardiology fellowship in the US. I have recently matched to an interventional cardiology position from 2022-2023. I used to hear that one needs to have "10 years experience" overseas before returning home to avoid compulsory government service. Does this still hold true?

2) How easy, or tough it is for one to join private practice in Malaysia. Do Malaysians (especially my colleagues and patients) appreciate a US-trained physician? I have not worked in Malaysia before and I am sure there will be a huge difference in the medical system back home. My concern would be how easy it is for me to develop my practice from scratch (learning the system at the same time).

3) Would you recommend me joining teaching hospitals for a couple years to learn the system before venturing into the private world? Like joining IJN or some of the university hospitals for instance.


Thank you very much in advance! If there is anyone who went through the similar path that you know of, kindly let me know. Appreciate your help.

This post has been edited by soulmate6063: Feb 1 2021, 04:41 PM

I have been away from home for many years, from medical school until fellowship. With COVID lockdown I have not been home for the past 2 years. Sometimes it makes me wonder if it is worth spending the rest of my life/career in a foreign country, far away from home, not able to see and take care of my family when they need me. Every time I go back, parents are getting older. And of course, the Char Kway Teow in Penang is unbeatable, after having tried most Malaysian restaurants in NY, Chicago, and LA haha.

Thank you. Yes, I have been following Pagalavan's blog but I dont remember seeing any posts about returning to Malaysia (I could have missed those). The blog is mostly about the issues of malaysian medical education. He did talk a little bit about practicing in foreign countries etc.

The physician salary in US is good, taxes are high too. At the same time, patients are more demanding. It is very common for patients to call/message the office with questions and doctors are expected to reply within 24 hours. One of my attendings in private is getting up to 30 medical questions/emails/messages on a daily basis. If we talk about money alone, I don't think there is too much of a difference between interventional cardiologists in US as compared with the private cardiologists in Malaysia. For eg, interventionists here make about USD 400-700k/year in private; those in academic center make about 300-400k. (Forget about the outliers like Samin Sharma who makes 5 mil/year). With such income you are at the highest bracket for federal tax ie. 37%. On top of that, we pay state tax (more than 10% in California), social security, medicare etc. So I am talking about half a paycheck just for taxes, excluding retirement plan and disability/malpractice insurance etc.

From what I heard (correct me if I am wrong), private cardiologists in Malaysia make about RM100k/month which is about RM1.2 mil/year on average. The good earners are making RM 300k/month upwards. Bear in mind our highest tax bracket is less than 30%, with no state tax.

This is just about the money, which I think is important but not everything. Maybe I have been away from home for too long, or maybe the travel ban due to COVID stirred up my emotion. Now at this stage, for me, family is above all else.

This post has been edited by soulmate6063: Feb 13 2021, 03:15 PM

Thank you for your note. Oh I did not know that there are a lot of Malaysians interested in coming to the US. There were about 7 Malaysians who matched in my year. I know there are a couple every year (excluding IMU-PMS students). The salary comparison above is only for interventional cardiology. For internal medicine I think US could be a better place to practice for several reasons. Hospitalists work 1 week on, 1 week off. Starting salary about $200k/year in academia, $300k in private. If you work extra shifts, $400-500k/year is possible. There are abundance of support from consultants in most hospitals. The downside is the lack of job satisfaction since hospital medicine is like the middle man and dumping ground for all other services.

A friend of mine first told me about the salary of private cardiologists in Malaysia. One of his family members work in private too but in a different specialty. He said it is a lot of money in private but you work really hard. (I am not sure how does that compare to the US but I would think US physicians have better work-life balance in general especially those in academia).