Story time.

Years ago, Cardiothoracic surgical fellowships in the US were being left vacant. Years of incredibly high salaries had created a glut of trained surgeons, and then the salaries crashed taking demand with it.

A well-known Midwestern hospital system hadn't had a fellow for a year and were were concerned about losing accreditation, so they accepted a mainland Chinese trainie with impeccable general surgery credentials.

First surgery the guy opens oddly, crooked and the wrong depth. The support staff are a little taken aback. He then proceeds to near kill the patient within a minute. Word from the room is that he ignored the staff surgeon, and had to be physically restrained so the staff surgeon stepped in to stabilize the patient.

It came out that the Chinese "surgeon" used connections and bribes to make it through his entire medical training in China. He was book smart and knew the material, but utterly incompetent in practice. He was immediately put on "research" leave and let go a few weeks later.

China is a poor, corrupt nation where one party controls everything. If a CCP boss decides his son is going to be a surgeon, it's going to happen. So 50% being unqualified by Western standards is very understandable.