[UPDATE]: Thank you to everyone who has helped and given advice. I'm seeing a lot of responses to my original post rather than my update further down in the thread. While it's appreciated, I now have a VERY clear understanding of every aspect and outcome of the "tough certification" pathway. I spent no less than 2 months researching, speaking to multiple AMEs (including Dr. Lou), and corresponding with advocacy groups. I'm leaving the thread up for the sake of others who could use the advice!