But the exams themselves, he added, hold foreign-trained doctors to a higher standard than Americans in order to pass.

In 2001, the Doer government introduced a medical licensing program to bring foreign-trained doctors into Canadian practice.

Willkie supported allowing foreign-trained doctors the ability to practice in small-town America.

"When some foreign-trained doctors get frustrated trying to pass American medical exams, they decide to risk practicing without a license."

Many hospitals wrote back that foreign-trained doctors need not apply.

More than 88,000 foreign-trained doctors are registered to work in Britain, including 22,758 from Europe.

Nationwide, about 40 percent of foreign-trained doctors fail the national exam on the first try, four times the rate of American-trained physicians.

The foreign-trained doctors who qualified tended to stay in the community, where they worked hard.

When spots in medical centers were vacant, foreign-trained doctors often recruited friends and relatives in their homelands to fill them.

Still, some hospitals in India are discovering that affordable costs and foreign-trained doctors may not be enough to make India a global health care destination.