Not just Americans, anyone from a country whose mother tongue is English. And not just this, English or at least passign the English exams is a requirement for

Not just Americans, anyone from a country whose mother tongue is English. And not just this, English or at least passign the English exams is a requirement for EVERY UIVERSITY DEGREE. I teach Tradtitional Chinese Medicine undergrads and postgrads, and they all need to pass the English tests to get their degree. Although the vast VAST majority can only speak a few words, something of a failure when you think that they study English in School for hours each day from middle school, all the way through Universty and only 1%(probably less) have any level of fluency. In my University of 20,000 students there are about 4-5 students whose English is good enough for me to have a conversation. Including the teachers, there is only one person in the Entire college who I would say has excellent English. So in short, take this with a pinch of salt, China does quantity, not quality.