There are two major exams for medical students pursuing postgraduate studies in India and the United States. In India, it’s the National Eligibility cum Entrance Test for Postgraduate (NEET PG), and in the U.S., it’s the United States Medical Licensing Examination (USMLE). As a medical student, choosing which exam to take may be overwhelming.

In this article, we’ll walk you through the details of each exam and compare the NEET PG vs. USMLE to help you decide the best fit for you.

What is the NEET PG?

NEET PG stands for National Eligibility cum Entrance Test for Postgraduate Programs. It is a national-level examination conducted by the National Board of Examinations (NBE) for admission to MD/MS/Post Graduate Diploma courses in various medical colleges across India. NEET PG is mandatory for all medical graduates who wish to pursue their postgraduate studies in India.

The exam is conducted once a year and consists of 300 multiple-choice questions covering various medical science subjects. The score obtained in NEET PG is used for admission to postgraduate medical courses in government, private, and deemed universities across India.

What is the USMLE?

The United States Medical Licensing Examination (USMLE) is a three-step examination process that assesses a physician’s ability to apply knowledge, concepts, and principles, as well as to demonstrate fundamental patient-centered skills that are important in health and disease and that constitute the basis of safe and effective patient care.

The USMLE is sponsored by the Federation of State Medical Boards (FSMB) and the National Board of Medical Examiners (NBME). It is a rigorous and comprehensive examination process that is required for all physicians who wish to practice medicine in the United States.

NEET PG vs. USMLE: Which Should You Take?

NEET PG and USMLE are two distinct examinations conducted in different countries, serving different purposes in the field of medicine. Here are the key differences between NEET PG vs. USMLE:

Location and Purpose

NEET PG, conducted in India, serves as the gateway for aspiring medical professionals seeking admission to postgraduate medical courses, including M.D., MS, and Diploma programs, offered by diverse medical colleges nationwide. On the other hand, USMLE is conducted in the United States and comprises a comprehensive three-step evaluation process designed to assess a physician’s skills and proficiency in applying medical knowledge essential for delivering optimal patient care.


To be eligible for the NEET PG examination, you must possess a valid MBBS degree from a recognized medical institution in India, along with a valid provisional or permanent registration certificate issued by the Medical Council of India (MCI) or the State Medical Council (SMC). Additionally, completion of the mandatory rotating internship on or before the specified date is a prerequisite. If you are currently undergoing your internship, you can apply but must fulfill this requirement before the counseling process.

On the other hand, eligibility criteria for the USMLE vary across its three steps. For Step 1 and Step 2 C.K. (clinical knowledge), you should be a medical student or graduate from a medical school listed in the World Directory of Medical Schools and meet the Educational Commission for Foreign Medical Graduates (ECFMG) requirements.

For Step 3, you must graduate from a U.S. or Canadian medical school with an M.D. or an equivalent degree. Moreover, the ECFMG Certification is mandatory, along with a D.O. degree from an AOA-accredited medical school in the U.S. or an M.D. (or equivalent) from a medical school listed on the WDOMS outside the USA and Canada.

Admission Requirements

To get admission into a good medical college in India, you need to have a good NEET PG score or rank. Whereas in the U.S., what’s considered during admissions is not only the USMLE score, but also your CV, letters of recommendation, personal interviews and other criteria. If you’re applying to colleges in the U.S., you may also have to spend months building a rapport with doctors in electives and learning about their system while securing letters of recommendation. Some students even choose to pursue a Masters in Public Health (MPH) to further strengthen their CV for the residency match program. And of course, high step scores are essential.

With NEET PG, results are declared within a month or two after the exam, after which admission into a college is based on your rank. With USMLE, you have to first choose your preferred specialty before even appearing for the exam.

Application Process

For NEET PG, the application process involves:

  • Registering on the official NBE website to acquire a user ID and password.
  • Filling out the application form following the provided instructions
  • Selecting your preferred exam center
  • Uploading scanned copies of required documents
  • Paying the application fee
  • Printing the filled application form with the transaction ID.

In contrast, the USMLE application process is more extensive. You must:

  • Visit the ECFMG website to create an account and request a USMLE/ECFMG identification number.
  • Complete the form, wait for confirmation, and make any necessary modifications.
  • Fill out the USMLE Step 1 application form with accurate details
  • Make the payment.
  • Complete Form 183 (which requires the sign and stamp from their medical school’s Dean).
  • Send the Form 183 to the specified address.
  • Wait for the scheduling permit (a crucial document for the exam day, usually received via email within 2-3 weeks.)
  • Book your exam date.

You can book your exam date at a Prometric testing center by visiting the Prometric website, selecting USMLE, and choosing your preferred location and date within the eligibility period.


Preparing for USMLE requires years of dedication and firm planning right from your undergraduate degree. Attempting the USMLE is not something you should take lightly, or try to attempt at the last minute, as it is highly competitive and involves multiple steps. It’s not just about writing an exam; the steps to getting a good score in USMLE are much more complicated than NEET PG.

In comparison, NEET PG is easier to crack, but competition is still pretty steep, making it tough to get a good rank. You can apply for NEET PG even in your final year of MBBS, but it’s a good idea to start preparing for the NEET PG exam right from the first year of your undergraduate degree to reduce your struggles at the end of the course. However, for the USMLE, applying in your final year of an undergraduate degree is not recommended because it may not give you enough time to prepare as the exam has multiple steps to complete.


The NEET PG and USMLE examinations differ significantly in their respective exam patterns.

NEET PG is a computer-based exam that lasts for 3.5 hours and consists of 200 multiple-choice questions. Each question carries four marks for a correct answer, and there is a penalty of -1 mark for an incorrect answer. The exam covers all 19 subjects from the MBBS curriculum, and there is no limit to the number of attempts.

The USMLE adopts a computer-based format conducted at Prometric centers worldwide. Step 1 is 8 hours long and consists of 200 multiple-choice questions. Step 2 clinical knowledge (CK) is 9 hours long and has 318 multiple-choice questions. Step 3 is two days long and includes 232 multiple-choice questions and 13 case simulations on the first day, followed by 180 multiple-choice questions on the second day.

You can attempt the USMLE exam up to four times. It covers many topics, including Medicine, Surgery, Pediatrics, and Obstetrics.

The Bottom Line

After considering all the factors, it can be concluded that both NEET PG and USMLE are important exams, but which one to take depends on your future plans. If you are planning to practice medicine in India, then NEET PG is the obvious choice. On the other hand, if you are planning to practice medicine in the US or Canada, then USMLE is the way to go.

It is important to research and understand the requirements and eligibility criteria for each exam before making a decision. Ultimately, the decision should be based on your career goals and aspirations. If you need more information, make sure to check the American University of Antigua College of Medicine’s resources and guidance for students interested in pursuing a career in medicine.


What is the difference between USMLE and PG in India?

USMLE and PG in India are different exams that serve different purposes. USMLE is an exam that is taken by medical students and graduates who want to practice medicine in the United States, while PG in India stands for Postgraduate Medical Entrance Exam, which is an entrance examination for admission to postgraduate medical courses in India.

Is NEET PG the toughest exam in India?

NEET PG is considered one of the toughest exams in India. It is an entrance exam for admission to postgraduate medical courses in India.

Is USMLE accepted in India?

The USMLE is an internationally recognized exam that people from different nations, including India, can register for and complete.

Which is the No. 1 toughest exam in India?

NEET PG, UPSC Civil Services Exam, IIT JEE, and CAT are some of the exams that are considered to be very difficult.

Which step exam is the hardest?

The difficulty level of each step of the USMLE exam is subjective and varies from person to person. However, many students consider Step 1 to be the hardest due to the wide range of topics covered and the depth of knowledge required.