Being an FMG, it will be more difficult than graduating in the US. Obviously, some specialties are easier than others (i.e., neurology, most of the primary care specialties [IM, psych, FM]). After you do well in India and garnish good letters (like everyone else), you'll have to prove that you are an objectively favorable candidate--that means USMLE. It is the only standardized format available to compare disparate medical educations. if you do well, you will open the door to more competitive programs. Some places will simply not take FMGs for whatever reason. It has partly to do with government reimbursement. IM me if you want to know more. BTW, I have firsthand knowledge of both tracks (I am a US Grad and my wife graduated in India).