The board of American Samoa's LBJ Medical Center has granted the hospital management a waiver to recruit certain specialised doctors who haven't passed the United States Medical Licensing Examination.
The waiver follows difficulties filling several key positions.
The hospital chief executive, Mike Gerstenberger, says five physicians have been given the waiver so the hospital can fill critical staffing shortages in the Emergency Department and the Family Medicine Clinic.
Mr Gerstenberger says LBJ continue to have shortages of physicians in many departments.
He says the salaries offered by LBJ, about one-third of the U.S. mainland salaries, simply do not allow the hospital to attract physicians with the US certification.