GURGAON, India -- Richa Singh and her classmates have sat through a lecture on cardiology, a video on heart disease and a rerun of "E.R."

Now it's time for their exam. An instructor pops a cassette into a tape player and words spew forth in an alien American accent: anxiety, apnea, atrium, capillaries. ... Tapping away on computers, they try to keep up and spell correctly. Ms. Singh falls short on both counts. Aorta becomes arota; cerebel replaces cerebral.

Ms. Singh is training for India's new knowledge economy. She isn't a medical student; in fact the 27-year-old is already a dentist. Instead, she's vying for a highly competitive job transcribing dictation from doctors in the U.S., which she believes will offer better career prospects.

India is experiencing a boom in offshore clerical services thanks to rising labor costs in the West, satellite communications and time-zone differences that allow transcriptionists to work while doctors in California sleep. The next morning, they awake to a hard copy of their patients' records.

Such commercial links helped pave the way for President Clinton's visit to India next week, says Richard Celeste, U.S. ambassador in New Delhi. For Americans, "India was always the blank spot on the other side of the globe. Today, it's the place where we do the other 12 hours of our business," he says.