Nobody in my residency program would have predicted I’d end up in venture capital. Certainly not me.
I immigrated to the United States from India with a straightforward plan: become the best physician-scientist I could and build a career in academic medicine. For the first chapter of my professional life, that’s exactly what I did. I trained in internal medicine, published over 100 peer-reviewed papers including in the New England Journal of Medicine, served as principal investigator on more than 65 research projects, and earned an EB-1A visa, the highest immigration classification for extraordinary ability in a scientific field. My research was incorporated into clinical guidelines and referenced by Harvard Catalyst.
By any academic metric, the plan was working.
Then I started noticing something. The clinical problems I was documenting in my research were the same problems that health care startups were trying to solve, often with solutions built by people who had never treated a patient. And the investors funding those startups were evaluating them with financial models, not clinical evidence. It struck me that the same skills I’d spent a decade developing (rigorous evidence appraisal, systematic analysis, clinical pattern recognition) were almost entirely absent from the rooms where health care capital was being allocated.
So I started investing. One deal at a time. And I discovered that academic medicine had trained me for venture capital in ways I never expected.
Systematic reviews taught me how to evaluate a market
In academic medicine, I conducted dozens of systematic reviews and meta-analyses. The process is methodical: define your clinical question, search the literature comprehensively, assess the quality of each study, synthesize the evidence, and draw conclusions, while being transparent about the limitations.
When I evaluate a health care startup, I’m running the same process. The “clinical question” becomes “does this company solve a real problem?” The “literature search” becomes competitive landscape analysis. The “quality assessment” becomes evaluating the strength of each data point the company presents, distinguishing between a rigorous multi-center trial and a cherry-picked case series. The “synthesis” becomes an investment memo.
The discipline of systematic reviews trained me to resist confirmation bias: to actively look for evidence that contradicts my initial hypothesis, not just evidence that supports it. In academia, that discipline produces better science. In venture capital, it prevents expensive mistakes.
Clinical practice taught me what adoption actually looks like
Research tells you what should work. Clinical practice tells you what does work, and why some things that should work don’t.
I spent years as an inpatient hospitalist managing thousands of patients annually. I saw every new technology, protocol change, and workflow innovation that came through the hospital. Some were adopted immediately because they solved a genuine pain point. Others were technically superior but required clinicians to change deeply embedded habits, and they failed. Not because the technology was bad, but because the implementation asked too much of people who were already stretched thin.
That experience gave me a filter I use on every deal. When a founder tells me their product is “better” than the existing solution, my first question isn’t about the data. It’s about the switching cost. How much cognitive load does this add? How many steps does it change in a workflow that clinicians have practiced thousands of times? What’s the learning curve, and who bears it?
These are questions you can only ask with authority if you’ve lived inside clinical workflows. No amount of market research replicates the experience of being the physician who has to adopt or reject a new tool in real time.
Peer review taught me how to read a founder
I’ve served as an editor and reviewer for over 30 medical journals. That experience, reading hundreds of manuscripts, evaluating the rigor of someone else’s methodology and conclusions, transferred directly to how I evaluate founding teams.
When a founder presents their company, I’m listening for the same things I looked for in a manuscript. Are they being precise about what their data shows, or overstating their conclusions? Do they acknowledge limitations? When I push on a weak point, do they engage with the critique or deflect?
The best founders respond the way the best researchers respond to peer review: They welcome scrutiny because they know their work can withstand it. The founders who get defensive usually have the same problem as researchers who overstate their findings: The underlying evidence isn’t strong enough.
The immigration story is the investing story
I don’t talk about my immigration background to be inspirational. I talk about it because it’s directly relevant to how I invest.
Coming to the United States from India, earning an EB-1A through research excellence, and building a career from zero in a new country teaches you something that’s hard to learn any other way: how to evaluate risk with precision. When your entire professional future depends on the quality of your work, when there’s no safety net, no family connections, no second chance, you develop an instinct for separating signal from noise. You learn to bet on evidence, not stories. You learn to be honest about what you don’t know.
That same instinct drives every investment decision I make. I don’t invest based on a founder’s charisma or a VC’s reputation. I invest based on whether the clinical evidence, the regulatory pathway, and the reimbursement economics support the thesis. If they don’t, I pass, no matter how impressive the pitch.
What academic medicine actually prepares you for
The conventional narrative about physicians leaving academic medicine is that they’re “burning out” or “giving up on the system.” My experience has been different. I didn’t leave academic medicine because I was disillusioned. I transitioned because I realized the skills I’d built (evidence appraisal, systematic analysis, clinical judgment, intellectual honesty) were more needed in health care investing than in any journal.
Physicians spend a decade developing the most rigorous analytical training in any profession. We’re taught to question evidence, resist bias, think in probabilities, and make high-stakes decisions with incomplete information. Those are exactly the skills that health care venture capital needs and almost entirely lacks.
I’m not suggesting every physician-scientist should become an investor. But I am suggesting that the skills academic medicine teaches you are far more transferable than most physicians realize. The next time you finish a systematic review, evaluate a clinical trial, or question a colleague’s methodology, know that you’re practicing a skill set that an entire industry is starving for.
You’ve been training for this longer than you think.
Harsha Moole is an internal medicine-trained physician-scientist with more than 100 peer-reviewed publications, including work featured in the New England Journal of Medicine. After years of clinical practice and gastroenterology outcomes research, he made an unconventional transition from the bedside to the boardroom by founding PhysicianEstate, a health care-focused venture capital firm.
Over the past seven years, Dr. Moole has made 22 early-stage health care investments across digital health, medical devices, biotech, and therapeutics. He has also built a network of more than 200 physicians from institutions such as Johns Hopkins and Stanford who help source opportunities and provide clinical diligence before capital is deployed. His core thesis is that physician-scientists with firsthand clinical experience are uniquely positioned to identify health care investments that generalist investors often miss.
His research background is reflected in his publication record on Google Scholar, and he shares professional updates on LinkedIn.
