I think that in general the entire project management “outline” is similar regardless of the industry or the country. There may be minor nuances that are different but overall, the concept is relatively similar. When I was interning, there was a big project going on across multiple sites in different countries. As someone mentioned, one of the key obstacles faced is time change. I remember the people that were working on the project would come in at work at 5am or stay until 10pm just to talk to their client or partners in another country. Another thing that comes to mind is different regulations in terms of testing. Each country has their own standards to medical devices and one of the issues is making sure that the testing down meets requirements in both countries. It takes a little bit of time and effort but it is definitely manageable.