My answer to Which city should I choose to appear from for USMLE step 2 CS exam?
USMLE Step 2 CS can to be taken in USA at 5 centers- Houston, Atlanta, Chicago, Philadelphia, Los Angeles. There are no centers in NY or Detroit.
Please understand the 5 centers are decided to cover entire country-North,South,East & West based on the location of the student. That is the only logic.
As far as IMG’s go, if you speak fluent and clear English then you will pass in any of the above 5 centers. Its not necessary for you to have an American accent. Just as you understand their English accent, American patients also do understand Indian english accent. All you need to be is maintain composure and confidence that is expected from a doctor.
I had a friend who failed in Houston and 3 other friends who passed in Chicago,Atlanta and LA respectively. They selected these centers as their relative stayed there- Comfort >Scare propaganda.
Hope this helps!