If your freind is a U.S. citizen having lived and studied in Germany all these years, and who now wants to come back to the US, he will likely be more competitive for non-PC residencies than you think, especially if he is from a top German school as assessed by Gourman.
The rest is just general info on this subject from my vantage point:
Though anyone of any country may apply to most U.S. medical schools, particularly private ones, citizens of developed nations will fare best if they have an exceptionally compelling and highly unique reason for applying to U.S. schools, as opposed to simply utilizing their home schools. U.S.
medical school admissions commitees will be strongly wondering ?What's the point??
Those that do decide to apply to U.S.
medical schools do well to have a much more compelling uniqueness beyond "I'm from (whatever nation) and wanted to study here" so as to possibly stand out from the U.S. applicant pool. Additionally, they will obviously need to be well financed.
Citizens of developing nations that are most successful at attaining U.S. medical school admission are those who are, more or less, on a mission. Usually, this takes the form of them being under their government or an
organisation who is sponsoring them to a attend a U.S. school so they may then return and improve levels of care in the sponsor's area(s) of interest. Such usually come with full support from the sponsor.
Those who are simply applying as individuals with more or less personal reasons are much less successful. The admissions commitees will be asking themselves, ?What's the point? Prestige? Higher-pay? Eventual emmigration?? They prefer to know that the admissions slot is being given to a citizen of a developing nation for very much more than just the applicant, and the personal world they will return to or come and create, any potential patients irrespective. They want to know that such an applicant is, more or less, a special arrow sent to hit its mark, and then return home--not one of the hoards who wish to use the US medical school slot as a ticket to their own personal or even family ends.
