I spent two weeks teaching first year medical students anatomy in February. It was an eye opener. Some of the students were great, motivated and curoius and probably just missed the cut-off to being accepted at a US med school. Some looked like they just stepped out of the hood.
We taught using prosections, or cadavers that had hte area of concern already dissected and the stude ntds were required to identify the important structures. This method compares favorably with active dissection in some studies asa far as tests are concerned. a lot of work in a short period of time.
The experience taught me that motivated students always look for ways to do well, no matter where they are and some of these were as good as my Tufts students. The bigger point is that as the doctor shortage gets worse, these students who do their clinical training in the US (New York, New Jersey) will no doubt be asked to fill the need. Also, some of the average students from other countrues will provide good medical care in thier countries where care is not always available.
So off shore medical schools aren't the very best but they serve a real purpose and have improved greatly over the years.