I will venture cautiously here since it is not a drug related topic....so - you can all disregard anything I say completely!
In my field.....which is not representative of medicine, surely, but - it is very much dependepent upon communication. Verbal communication is a key element to the accuracy of pharmacists (this has been documented in studies). My state - CA, has many URM's - not only as residents, but also as immigrants who qualify to enter pharmacy school. These folks are very smart and capable in test scores and on paper, but their verbal language skills are not sufficient to communicate effectively with prescribers (or their support staff) and patients - which is what my field does - communicate!
So...about 8-10 years ago (I can't remember exactly), my state instituted a verbal qualifying examination to successfully graduate from a CA pharmacy school and for those applying for a license who are foreign graduates. The idea being that by the time the student has finished his/her graduate studies, he/she should have enough working usage of the language to be able to pass the licensing examination. (In other words - know what obtunded means....) If the student doesn't pass the exam, the student doesn't graduate until he/she does - a great motivator to learn the language!
Now...the major differences in our fields is your examinations are not only earlier (Step 1 is before rotations, I think????), but they are more frequent. We have one - unless it is for a board certified residency...then there is another in the speciality.
I have my own opinion, but it is irrelevant.....just thought I'd "communicate" the experience that pharmacy has had with the situation, for what its worth.....hmmmm....nothing!