Let me tell you something. If you don't get in through CEHPEA assesment for PRA/PGY2 then what do you do? There are multiple physicians with 10+ years with residency/fellowship including those who trained at the Aga Khan University Hospital, where a family friend couple of mine trained and could not get placed. They matched through CARMS in their specialties. As a matter of fact let me tell you Rajni, the way it works is if they get a more qualified applicant, they take them. Why would they take a PGY-1 in surgery who has no experience in surgery as opposed to a surgeon who trained in India at AIMS, could not get through PRA/PGY2 assessment. We are compared to the Saudi candidates arriving here who have done residency in their home countries. Saudis are not hired to be trained but for service just like IMG's who did residency in home countries, are hired for service! Works just like this in top notch places in the USA as well!