There are 50% more us residency spots than there are us medical graduates. the situation is likely the opposite in countries that send their medical graduates

There are 50% more us residency spots than there are us medical graduates. the situation is likely the opposite in countries that send their medical graduates to U.S. residencies. License to practice in most us states only requires a 1 years internship and passage of usmle step3. Most residencies are 3-4 years, but those are required to pass board exams and usually required for hospital credentials. But you already have a license to practice while in residency (where in fact you are already practicing medicine (although with some supervision)).