Indeed malpractice insurance is a big deal in the US... But one way around it is to work for a Hospital or HMO, which pays your malpractice insurance for you, but you do get paid at a lower amount as compared to your private practice colleagues...
When I was a researcher at NYU medical center in NYC in the early '90s, I worked for two Neonatologists and they made about $160K, which was at the lowest end of the spectrum, but they were fully qualified...
Contrast that with the OB/GYN doc who was clearing $1,000,000.00 But he was smart because the hospital was paying his malpractice insurance, as there were for the Neonatologist...
He was/is very lucky because many people are choosing not to specialise in OB/GYN in the US because of the risks involved in that specialty, because you are on the hook for any malformations/disformities of a child, up until adolescence.... and the malpractice insurance is astronomical!