New Delhi, Jan. 21 -- Over 50,000 Indian medical graduates attempt Middle Eastern licensing examinations annually, yet industry estimates suggest first-attempt failure rates between 40-60 percent - often attributed to inadequate preparation materials rather than lack of medical knowledge.

In an apartment in Kochi, at 2 a.m., a young physician prepares for an exam that could change her life. Her textbooks are from 2017. Her PDF question bank contains errors no one has bothered to fix. She has 47 days until the licensing examination, a full-time hospital job, and the growing suspicion that she is preparing for the wrong battle entirely.

This scenario repeats across thousands of households where medical graduates from India, Pakistan, Egypt,...