I was not aware of this until I spoke with a local MD. If a Med school graduate is unable to obtain a license to practice in the US, they can go abroad or gain employment at the VA. There are requirements at the VA but they are much easier to meet than those for state licensing. After a period of time the VA grants full licensing and then they can go out into the private sector. I got this info from a retired MD who teaches at an area medical school.
This is not the entire problem at VA but it does not help.
The present problems are related to cleanliness and procedures.
This brought to mind a (Dr.) Michael Swango who killed his patients across the US and in a couple of third world countries and who, as I recall, also practiced at a VA hospital. He Is presently in prison in the US.