"her med school tuition was around $6k/yr in a country where median household incomes are $2-3k per year and she'd end up working for $700-800/mo working 70 hour weeks and best case $2k/mo in 5-7 years"
A $6k a year tuition is double the median household salary for most Vietnamese. And unlike in developed counties, student loans are essentially non-existent for the majority of the population. To get a loan, it means going to a tattooed snaggle tooth guy wearing a flower shirt who exchanges gold and foreign exchange, and getting a double digit monthly loan. Best case, you are lucky and have land you can mortgage or family abroad you can beg for remittances. Additionally, tuition is paid up-front - not monthly payment plans. Additionally, the universities didn't provide half of the materials needed like scalpels or gauze - that came out of pocket at US prices.
Additionally, for someone from the bottom half of society, like my SO's family, social security and public services are non-existent, so they are dependent on their children sending them $150-200/mo while their kids are paying $250/mo in rent and $100-150/mo in incidentals on best case a $700-800/mo salary.
If you are a woman from the bottom half of society, like my SO and her peers - it is almost impossible to afford 8-10 years of no cash flow. If you are an 18 year old woman in the Central Highlands or the Mekong Delta, immediately working in a factory with a subsidized dormitory and food means you can immediately start sending cash to family to help them out. Alternatively, earning $15k-$20k working in the "unregulated vice industry" in Singapore, South Korea, the UAE, and others starts looking extremely lucrative (usually referred to work there by that snaggle tooth guy I mentioned). Best case, you get an arranged marriage with someone in the diaspora in the US or become a "Viet Bu" in Malaysia or Singapore.
My SO was literally the only person from her social class at her medical school (Vietnam's equivalent of Harvard Med) - everyone else were the children of doctors, bureaucrats, diaspora Vietnamese, businessmen, MPS officers, and other crème-a-la-creme of Viet society.
For people in my SO's case who somehow even make it to medical school, they all try to leave to practice in Japan (which my SO did), Taiwan, South Korea, or the US as soon as possible becuase it is the only way they can even recoup the cost. And this is exacerbating the medical health crisis in much of Vietnam, because a rural government doctor in a village like my SO's (if they are lucky enough to even get a doctor) would earn a $100-200/mo government salary that is almost always late.
Like, there are massive issues in the US, but to even compare the that to those faced by the bottom half of a developing country is legitimately out of touch and actually insulting as it trivializes the pains billions of people face across developing countries.
I'm still not seeing the bad investment here.