This will come up most often with careers that have governing bodies. In professions like engineering or medicine, where your mistakes can cause real harm to people, we don’t want just anyone walking off the street with a piece of paper saying they’re qualified. Instead, there’s a trusted body, like the National Society of Professional Engineers, or the American College of Physicians, and they in turn will vet these schools to make sure that their programs are actually good enough to keep their graduates from hurting people instead of helping.
This vetting process is the limiting factor here. There are about ~150 medical schools in the US that need to be trusted, and they will produce the large majority of the doctors in the US. The ACP isn’t necessarily going to vet every medical school in Europe in the same manner, because they might only get a doctor coming to the US from those schools every few years at best. It is far far easier (and cheaper) to just offer a single recertification process as a catchall.
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