I think that probably varies by area, but where I live a license requires a a pre-trip test, road test, and a driver’s medical exam. Teenagers can’t drive one. A variety of health conditions are prohibitive. They are far stingier with points from tickets. You can lose the license to drive one.
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He knew how to read manuals and pass tests, but wanted to learn how to make a big truck go places and not crash into things, and they don't teach that well.