Curious - does Vancouver have an especially bad reputation for medicine, or did you pick the city/country arbitrarily?

Canada's medical training program seems to me to be reasonably rigorous; as an outsider it doesn't seem worse than a typical American medical program. Unfortunately it also suffers from severe (artificial!) shortages of doctors.

How else do the third world country washout doctors end up in a rural clinic in nowhere America and end up with the Vancouver accent?

Residency on the West coast in Canada. Always.