marygold, you are right about MBBS preparation and exam steps.  i know writer will comment on this, but i also would like to tell you that not all readers want to know so much specific about steps of exams for USMLE and other stuffs related to residency in usa.  prolly you are a MBBS who is doing residency here, but not many people know about all the steps about this.  i guess writer wanted to give some general idea about residency and USMLE exams rather than going into detail on this.  the story is not based on residency here, its based on different part of human life and relationships. 

as far as bangkok is concerned, i think nepali used to go to bangkok before we have test center in Nepal.  at least that is what i heard when i was young.  you are right about J1 and H1 visa and also right that residency is not like graduate study where you need to study and pass the test.  they do have some presentations and minor tests though, right?  basically they are paid for work while learning and work their butt off.  its not easy to know about every field, but i still was amazed with writer knowledge about locations, and education different education background.  great work.