People don't leave because they can't cut it; they leave because they find some other place that welcomes them, lets them express themselves, and rewards them according to their merits.
"It's true that friends and former colleagues back home surely have more lenient work schedules and a different perspective on the work-life balance, but I found that there is a different appeal to working in the United States that outweighs long vacations."
"I disregarded established paradigms and suffered for it through the peer-review process. To avoid a barren expanse, I developed side projects and brought along willing medical students and medical residents."
The FJI's wish-list for changes may be long and uncompromising but this doesn't mean it is unrealistic, as illustrated by the Juan de la Cierva programme.