Ankit Agarwal

Most people don’t understand that the Indian bigco CEO phenomenon is mostly an immigration story. Indians are FAR more likely to be tied to employment visas than other nationalities, so they couldn’t easily start companies. The 1990 Immigration Act created the modern H-1B/EB green card system. As Indian demand exploded, the 7% per-country cap turned into decades-long backlogs for Indians. Indian tech workers stayed tethered to sponsoring employers in a way Europeans, Russians, Taiwanese never had to. Founding a company means risking your status, resetting a green card path, or finding another workaround (now usually O-1 or EB-1). European/ Russian /Taiwanese immigrants don’t face the same trap. Their countries don’t hit the 7% per-country cap, so demand stays under the limit. A German or Russian engineer on H-1B can get a green card in 1-2 years and leave to found a company. An Indian engineer doing the same job has to wait 20+ years. The 1965-1989 Indian cohort was much smaller but not yet trapped by today’s H-1B lottery and India backlog machine. That’s why you see so many Indian founders from that era: Vinod Khosla (Sun Microsystems), Sanjay Mehrotra (SanDisk, before becoming CEO of Micron), Kanwal Rekhi (Excelan), Suhas Patil (Cirrus Logic), Desh Deshpande (Sycamore Networks), Pradeep Sindhu (Juniper Networks), etc. My dad is a 1972 IIT grad who came to America for a PhD. Most of his IIT friends are successful entrepreneurs. My cousin took the same exact path (IIT>CMU) in the 1990s and most of his friends worked their way up corporate jobs because they needed employment sponsorship. IMO this is bad for America. We took the highest-conviction risk-takers on earth, people who crossed an ocean and left their families behind, and forced them into the lowest-risk career path. Fortunately this has been loosened in the 2010s with O-1 and EB-1A workarounds but it’s still much more challenging for Indian or Chinese founders.

Excited to see that we are getting the stapled Green Cards for all legal immigrants with high paying jobs and graduate degrees like we were promised. Thank you @chamath @DavidSacks & friends for your leadership on this.

@FiSurgi Had a generationally spectacular run over the past 5 years in particular. My concern with this sentiment is that it has led many in my generation to stay out of the market thinking “the game is rigged” but in reality boring public market ETFs have been a great bet 2/

@FiSurgi Easy to point at individual examples, but have private markets disproportionately outperformed (after fees) public markets in the past 15 years? Have public markets underperformed historical predominance over the past 10-15 years? Data would suggest not and public markets 1/

Agreed The game changed. It used to be the everyday normal person could create life changing wealth from the public market. Companies going public late in their journeys hurt everyone. The rich get richer and the rest of us get table scraps.

@theficouple VXUS in 2025 with a lot less work.

People will say real estate is a scam or "not worth it". We paid $485k for a 5-unit deal and put 8% down with seller financing. All in we invested ~$45,000 and the cash flow is $1,100/mo. Thats ~30% cash on cash return + appreciation. ...Show me an index fund that does that.

@7Saturdaysaweek Prepare for sequence of returns risk in first few years of retirements through having TIPS or other source to draw in first 5-10 years and/or having high tolerance for variability in income in first 5-10 years based on returns

@7Saturdaysaweek True although reassuring that Bengen re ran study up to present essentially (up to retiring in 1993, run through 2023 I believe) and showed his 4.7% rule still held up. Probably best way to prepare for unlikely (but possible) that future will be worse than worst case is 1/

The 4% rule is great for back of the napkin math. But it sucks as an actual withdrawal strategy. Why? Because it doesn't adjust over time to prevent: - overspending and running out, or - underspending and dying with millions more than you want to

@7Saturdaysaweek Average SWR was 7%, with adjustments up for inflation. Worst case scenario (30 year period starting in October 1968) was 4%/4.7% and adjusting up for inflation each year. But agree that should/can be used as a base and need to re adjust over time. 2/

@7Saturdaysaweek Agree with your second point (risk of underspending) but overspending/running out is not a risk unless you believe markets will perform worse than they ever have in a 30 year period over past 100 years. Trinity study (or updated Bengen study) calls 4%/4.7% worst case scenario 1/

@nickgraynews Tour the anthropology museum with Rodrigo Grimaldi (I booked on Airbnb) and get tacos at Tacos Los Alexis.

I'm going to Mexico City next week I'll be staying in the Polanco area Any suggestions? Deep cuts appreciated But if you suggest Pujol then I will block

@drdanchoi @drharrislakers And drove consolidation and meaningless “quality” measures which led to some of the increases. And yes I’m a PP physician.

@drdanchoi @drharrislakers Costs have gone up post ACA less than pre ACA and also costs were less due to subsidy. I see issues with the ACA as well but let’s be honest about impact (more insurance coverage, lower costs for many people in immediate aftermath, “bent” the cost curve but not nearly enough) 1/

The ACA will “cut the cost of a typical family’s health-insurance premium by up to $2,500 a year” said President Obama in 2008

ChatGPT response to me today: “..I’m a doctor but not your child’s pediatrician, so take this as general info and double-check with your pediatrician before giving it”

@SprakerMDPhD @SimonLo21054188 I mean…PACE-B post-hoc analysis of the patients who received SBRT did show a difference between the patients who received linac based SBRT vs Cyberknife based SBRT. And no, I currently do not use a Cyberknife (but have in the past).

@SimonLo21054188 True There is data that planning protocol non-compliance in trials can have a significant impact on cancer control and toxicity. There is no (strong) data that machine type has the same effect.

If you are a physician posting #MedEd about radiation… SABR/SBRT not Cyberknife SRS not GammaKnife We are educating patients not selling machines, right? Right?

@DrSuneelDhand I’ll take the other side of the bet if you’re putting $ on it

My prediction: Within a few years we are going to see a TIDAL WAVE of lawsuits against Ozempic (semaglutide) and some TERRIBLE side effects. Don’t entirely blame the drug companies however. It’s the IRRESPONSIBLE pharma-obsessed medical profession dishing this out like candy

Today marks six months since I took office as Mayor of San Francisco. We still have a lot of work to do—but we’re showing what a new era of collaboration and action looks like. Since our 100-Day mark in April, we have passed a budget that closes an $800 million deficit and still supports our recovery, made progress on public safety staffing, taken aggressive steps to tackle the homelessness and behavioral health crisis on our streets, and introduced legislation to speed up permitting and create more housing. Together with the Board of Supervisors, we have navigated some real challenges, and we are delivering results for San Franciscans every day. And something else is happening alongside all of this: renewed optimism. You can feel it in the way people are investing and betting on San Francisco again. That energy isn’t just anecdotal—it’s backed up by the numbers. These stats show our progress: ➡️Overall crime is down 27% citywide from last year—and down 45% around Union Square and the Financial District. ➡️Tent encampments are at their lowest levels since before the pandemic—down by a quarter since March. ➡️Nearly 400 new shelter and treatment beds have come online since January, with another 1,000 expected by the end of the year. ➡️Muni ridership is at its highest level since the pandemic, with weekend numbers nearly back to pre-pandemic levels and still rising. ➡️San Francisco’s office vacancy rate is trending down, with the third straight quarter of improvement—and the largest quarterly decline in vacancy since early 2015. ➡️Moscone Center convention bookings are up 50%, with associated hotel bookings forecast to be 60% higher than last year. As we finalize the budget, we are also advancing key legislation—Family Zoning to keep San Francisco affordable for the next generation, PermitSF to cut red tape for small businesses, and a plan to move RVs off our streets and offer better options to those living in them. We are staying focused on what matters: public safety, clean streets, and a strong economic recovery. And we are going to be relentless.

X-torial: Cleaning up the misinformation about @JoeBiden and #ProstateCancer that I am reading everywhere. The purpose of this is to provide education from someone who treats and studies PCa for a living, lead the USA @NCCN PCa guidelines, hold leadership in @NRGonc @theNCI @US_FDA and dedicated my career to help men and their families suffering from PCa @nytimes @WSJ @FoxNews @CNN @NBCNews @Reuters @ASCO @PCFnews @DeptofDefense

Small businesses and homeowners in San Francisco: permitting is about to get easier. Today, we announced reforms and legislation that will make permitting faster, simpler, and more transparent. These ordinances will cut red tape, save time and money, and finally make our permitting system work for the people it’s supposed to serve. Here are some examples of what this means in practice: ➡️ No more permits for sidewalk tables and chairs—putting $2,500 back in the pockets of small businesses and saving them valuable time. ➡️ No more permits and fees to put your business name in your store window or paint it on your storefront. ➡️ No more trips to the Permit Center to have candles on your restaurant’s table. ➡️ No more rigid rules about what your security gate must look like so businesses have more options to secure their storefronts. ➡️ No more long waits or costly reviews for straightforward improvements to your home, like replacing a back deck. ➡️ And we’re getting rid of outdated rules to give downtown businesses more flexibility with how to use their ground-floor spaces—because if adding childcare centers and gyms will help bring companies and employees back downtown, we should support it. In addition, every city department involved in permitting will track timelines and publish them online. We’re building one system—simple, accessible, and focused on the customer. And we’re not done. In the coming months, we’ll roll out a consolidated permit application and bring more of the process fully online. When we make it easier to open a business, improve a home, or invest in our city—we don’t just support individual success. We fuel our city’s economic recovery. We attract more customers, more residents, more small business owners—and with them, the revenue and energy that San Francisco needs to thrive. Learn more about the initiative at sf.gov/permitsf

In this episode of @gpohlmanmd's "The Prostate Health Podcast", Dr. Steven Kurtzman and @AnkitAgarwalMD, discuss expanding access to LDR brachytherapy by partnering with urologists to establish new programs across the United States. prostatehealthpodcast.com/107-the-expand…

Thank you for having us on to talk about LDR brachytherapy Dr. Pohlman @gpohlmanmd ! Training from @tjroycemd and @RonaldChenMD inspired me to pursue Brachy as a career. Love being able to bring high quality Brachy to communities and patients around the US now!