Foreign trained surgeons after getting u.s. training ie fellowships are not able to work as they are not allowed by ABMS subspeciality to give board exam. (it is not that they cannot pass they are not allowed to give exam) so they can get license to practice medicine but they will not be allowed to get a job as job needs board certification even the ones given by government.
Unless they abandon their previous training and residency and do residency again in what they are allowed to do (even though they are u.s. citizens or permanent residents they are discriminated from getting residency spots as their crime is to get trained abroad). they are not allowed to give boards and so employment.