The department of Health in American Samoa says it thinks LBJ hospital is trying to cut local doctors from its staff by advising them to sit a United States medical exam.
Its director, Dr Ivan Tuliau says doctors at the Pago Pago hospital have graduated with the appropriate qualifications from countries including New Zealand and Fiji.
He says having them sit this new requirement would be a repeat of training they've already received.
Dr Tuliau says only local doctors are being told to sit the test.
"It's really pertaining to American Samoan Fiji school of medicine graduates. They're still hiring Fijian nationals that graduated from the Fiji school of medicine along with me. My classmate can come in work here without sitting the exam but I can't. So that's why we're saying its more discriminatory against the locals."
Dr Ivan Tuliau of American Samoa's department of health.
But, chief executive of LBJ, Patricia Tindall dismisses the claim and she say all practitioners employed by the hospital must have pass the exam in order to practice medicine there.