This is absolutely a reality I am vouching for. Right now the AMA (American Medical Association) actively places roadblock in the way of foreign doctors who want to practice in the US by forcing them through additional testing and years of training. We commonly joke that the purpose of one of our medical exams, Step 2 CS, functions to weed out foreign non-English speaking doctors (there is a whole section of the exam devoted to english proficiency), and for AMA to profit from the exam admission fee.