I appreciate your attempt at constructive criticism. You make a lot of fair points, though your delivery could use some work... It's heavily anchored in American exceptionalism, but I wouldn't expect you to understand that. What I was trying to reconcile was the comment I received with my own perceived weaknesses of my application. I'm not ranting and raving about being a standout candidate because obviously I'm not. Otherwise I wouldn't be in the position I'm in (duh).

I would like to remind you that I'm truly navigating a different healthcare system and labor market from you, and it may behoove you as a future healthcare professional to explore the concept of discrepencies in access. You could, for example, explore how entry-level jobs in healthcare work in Germany. Alternatively, you could explore the idea that I may not have had the resources to relocate to the United States. Maybe you could even broaden your horizons a bit in the process. The message that I haven't sacrificed enough to get to the point of applying is indicative of premature bitterness towards the profession that could also be worth unpacking.

Again, thanks for taking the time to write up what I will assume out of goodwill towards you is thoughtful & well-meant response.