As well as a US license, I have an international license. My exam involved driving a Kamaz with a loaded bed (similar to one pictured). Try parallel parking, doing a 3-point turn and a hill climb in that thing. My right arm gained an extra muscle from changing gears all the time. And Kamaz has a completely different gears layout. It’s 1, then 2 to the right and 3 is back to the left and down. Failed the first time, succeeded the second time. Interestingly enough, I failed because I hit the curb. Hill climb was kinda easy compared to making sharp turns with no AC in a 90 degree weather.

*My US driving exam was done in my brother’s ‘03 Celica with a manual.

2nd picture is the shifter layout.