A New Group of Interns.

In 1948 Congress voted to let foreign medical-school graduates come to the United States for further training, inadvertently establishing a two-tier system of medical practice. American graduates generally took their internship and residency at prestigious university-based hospitals. The foreign graduates went mostly to fourteen hundred smaller community and veterans' hospitals, where they staffed emergency rooms and treated the poor who could not pay for care.

Tough Exam.

The Educational Council for Foreign Medical Graduates (ECFMG), an agency developed by the American Medical Association (AMA) with legal backing from the government, was created to regulate the placement of these interns. This agency required special seven-hour tests in English and general medicine for the fifteen thousand foreign-trained doctors. The grueling and deliberately tricky tests were meant to fail 50 percent, causing some eight thousand foreigners to lose their visas. The exams were first...