Why this doctor left McKinsey and US after 13 years to return to India

After more than 13 years of building a career across some of America's most prestigious institutions, Dr Neeraja Nagarajan has done what many Indian professionals abroad only ever talk about — she moved back home for good. And she wants people to know exactly why.

In a LinkedIn post that has since struck a chord online, the former McKinsey & Company associate partner opened up about trading a well-established life in the United States for a fresh start in Chennai, three months after relocating permanently. By her own admission, almost nobody around her thought it was a wise move. "Every rational framework — and most well-meaning mentors — said stay," she noted, before going on to explain, point by point, why she didn't listen.

A journey that began with public health

Dr Nagarajan's American story started at the Johns Hopkins Bloomberg School of Public Health, where she pursued a degree in public health. It was here, she wrote, that she was pushed to question assumptions she had carried since childhood about privilege and social justice — an experience she candidly described as a fairly common one among Indians who move abroad, admitting she was no exception to that pattern.

From there, she went on to work at Brigham and Women's Hospital, a stint that turned out to be a turning point in her career. It was during this period, filled with what she called plenty of tears and self-reflection, that she discovered her true professional calling wasn't at the bedside treating individual patients, but in fixing broken systems altogether.

The McKinsey chapter

That realisation eventually led her to McKinsey & Company, where she would go on to spend more than seven years, rising to the position of associate partner. She has credited the global consulting firm with teaching her the mechanics of real-world decision-making — essentially, who actually holds the power to approve an idea, and what it takes to convince them. It was at McKinsey, she said, that she finally learned how to convert good ideas into real, executed outcomes.

Reflecting separately on her exit from the firm last month, she looked back fondly on the scale of work she got to be part of, including initiatives that contributed to vaccinating large populations. The single biggest takeaway she said she's carrying forward isn't a strategy framework, but a leadership philosophy: building teams of exceptional individuals who achieve extraordinary results together, without losing their individual identities in the process.

She never stopped planning her return

What stands out most in her account is how deliberately she kept the door open to India throughout her 13-plus years abroad — even while holding a long-term US green card. She never surrendered her Indian passport. On her very first date with the man who would later become her husband, she made it clear upfront that her long-term plan was to return home, and that the relationship could only move forward if he was on board with that. Even her choice of McKinsey, she pointed out, was strategic — an international firm rather than a US-only one.

Why she finally made the move

Asked to sum up the "why" behind her decision, Dr Nagarajan pushed back on the idea that any major life choice is ever driven by a single factor. According to her, career moves are never purely professional — they're always tangled up with the personal and even the political.

For her, the pull home came down to a mix of reasons: building something meaningful that widens access to healthcare in India, hearing Tamil spoken around her every day, working alongside leaders who genuinely inspire her, and simply getting to wear Indian handloom again. Today, she's applying her public health and consulting expertise to the healthcare sector in Chennai — choosing, in her words, to stay rooted at home while still building for the world.