Failed states were once poor almost by definition.

ECONOMIST: Wealth, poverty and fragile states

And therefore the residents training at these programs will be by their definition poor physicians.

FORBES: What Do You Think Of The "Do Prestigious Residencies Mean Better Doctors?" Article In The Atlantic?

By this definition, the report finds 7.8 million people were fuel-poor in 2009, across 2.7 million households, more than previously thought.

BBC: Fuel poverty to rise to 8.5m, report warns