Which one is tougher, AIIMS PG or USMLE?

Though both the exams, AIIMS PG and USMLE are tough but definitely USMLE (The United States Medical Licensing Examination) has an upper-hand, having the more tougher topics to deal with.

There are certain reasons to prove the above statement - 

• Residency - In AIIMS PG, a good rank guarantees a residency while it’s not in the case of USMLE. A good rank in USMLE doesn’t play a role in securing a residency.
• The other factors playing a role in USMLE admission are robust extracurricular, US clinical experience and research experience. Though, it’s entirely up to the programme director to decide.
• Subject – Students securing 1st AIR can choose their subjects according to their own preference in AIIMS. Though, securing AIR in top 10 in AIIMS also does the same. But in USMLE, it is a bit different. In USMLE, scoring an absolutely high score such as 270+ won’t assure you of getting a subject involving intervention.
• Interview – For USMLE, the interview is mandatory. Students even after scoring ridiculously high scores need to sit for an interview with the programme director who further decides the matching. This is a subjective assessment and marks solely are not responsible for the results.
• Visa – The procedure for VISA is indeed a lengthy one. Students face a lot of issues while applying for VISA along with the uncertainty of being cropped up at any stage of the lengthy process. 
• Finance – USMLE is a lot more expensive compared to AIIMS. The cost estimated to cover all the steps is around 10 lakhs. The estimated cost includes the travel and living expenses in the US. Students also need to do the USCE (US Clinical Experience) and the fees are separate for that. After addition of the USCE fees and other expenses, the estimated cost is around 15 - 20 lakhs.
• Attempts – In AIIMS-PG, the number of attempts doesn’t matter neither the previous rank. Though, in case of USMLE, if any student fails in any of the steps then they can reappear but the failure is marked against them which decreases the chances of matching. In USMLE, failure isn’t the only issue, if any student scores a poor result, then there are no chances of improving that. Students will be stuck with that score for 7 years.
• Timing – Students after completion of their internship can anytime apply for AIIMS PG exam. Though, students can appear for step 1 during their med-school while the preference is given to the fresh graduates for a better chance of matching.
• Level of questions – The questions of the USMLE exam is concept based which needs memorising power than the questions in the AIIMS –PG exam.

AIIMS–PG is undoubtedly the best among the Indian exams. It is indeed the best test for assessment of correlation and concepts. Though, USMLE tests have more thorough questions with more questions and separate tests for pre/para clinical subjects and clinical subjects.