I will add this to the discussion:
When I was in community college, we had a science professor who was a Caribbean grad. I could not understand why he was teaching at a community college and I just assumed that he failed boards. Turns out, he and some others, were caught by the FBI in an elaborate Medicare scheme where they were working under a licensed doctor and seeing patients when they had no medical license themselves. They were basically getting paid to make the ringleader doctor a ton of money. I don't know what the punishment was but the case is online if you type in his name.
And what was the outcome of that?...
He recently graduated a psych residency and is now an attending LOL! I'm sure the background checks disclosed all of this but the powers-that-be gave him the green light.
Personally, I think this doctor will again bend the rules somewhere in his career.
My point is that all these adcoms and administrators talk about only accepting the best of the best but I keep encountering all of these ethical outliers.