The US is mainly your medical history. Was in Europe years ago and needed a medical. Mien Deutsch wasn't up to explaining to the nurse that I only need the FAA medical and not the LBA. They do the EKG on a treadmill, hearing test in sound proof booth, etc. The doctor's English was better than mine and he tossed the LBA paperwork but said after the office visit, a German applicant would head off to a hospital to have blood drawn and it would take a few days to get the lab work done. No walk in and walk out with your new medical.