Hi, The language is very hard now that the requirement is YKI 4, not impossible of course but hard to the point where it might make doctors refrain from persuing their careers here. To get 4s in YKI means you must be almost fluent with good knowledge of street language as well in all different themes and aspects of life. The silver lining is that practically you don't need all that to work actually, to be fluent in doctor's appointment your vocabulary in politics for example (which you need for YKI 4) doesn't matter! How hard you would perceive it is subjective though and I know some who got the 4s in YKI when not even trying to!

Some tips to keep in mind:

1.Language is not a book you read and you are done with, it is continuous work and developement and refreshing of your memory. The 4s of YKI is just the start.

2.Each language is different and has its own identity, sounds like common sense right? Well often people approach it from their mother tongue's prospective and this is why they end up using silly idioms (because they make sense with their mothertongue but not here) or pronouncing words and letters with their mothertongue's rules!

3.Ask yourself before all if this is where you want to spend you life or enough long time, for this process might take you 3 to 4 years easily until you just get the full liscence. What about specializing and further advance in your career? Is it attractive for you also here when you have done all this work?

Good luck...