re: Since many of the Tawainese never will take the USMLE I'm not sure the ones who are unqualified are every screened out of the system.

Is not a reference to the world revolving around it, but a reference to the fact that tests that attempt to control retakes eliminate many students who don't know the material, as opposed to students who have memorized one sentence answers. Albeit the USMLE is not as restrictive as other professions in what they do allow -- the NBME (org who oversees the USMLE) does not restrict the total number of attempts, but does restrict the earliest retake time and the max number per year (3x max in a given year). Here is a quote from the USMLE website. Further many states have the 7 year rule for passing all required tests. Since these students to my knowledge never take a restrictive test at all ... is there ever a time when they are adequately tested.

Cheating does happen everywhere, to different degres. But, constant reprimands and no concrete action to one particular group is somewhat enabling.

There is a reason why many don't support multiple choice testing over orals -- which have their own downside -- I'm sure they'd even pass those with enough $$$s.

Keeping students in a school for $$$s without concern for quality says something about the school itself.