Enamed: what changes for medical students?

The MEC (Ministry of Education), together with the Ministry of Health, announced this Friday (19) a provisional measure that transforms the Enamed (National Medical Training Assessment Examination) into a mandatory requirement for practicing medicine in Brazil. The provisional measure that makes the decision official was signed by President Luiz Inácio Lula da Silva (PT).

Currently, presenting a diploma is sufficient to obtain CRM. However, with the change, students who enter medical courses after the measure is in force will need performance considered proficient, above 60 points on the Enamed, to receive registration with the Medical Councils. What changes for students?

Test will be carried out at two stages of the course
According to the provisional measure, which establishes the exam as mandatory, students must take the test at two different moments: at the end of the fourth year, the result of which will have a diagnostic nature; upon completion of the course, to certify proficiency. Approval in the second stage will be a mandatory requirement for registration with the regional medical councils.

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Students and graduates who pass the exam with a performance considered proficient - equivalent to 60% correct answers - will be considered fit to practice the profession. The test has 100 objective questions, based on the National Curricular Guidelines.

The measure is valid for new students starting in 2026
The measure will only be valid for students who enter medical school after the measure is approved. Students who are already pursuing their degree must take the exam, but the grade will be evaluative in nature and will not be a prerequisite for obtaining professional registration.

The test will be carried out every six months, allowing all students to take it in the final semester of the course. Furthermore, the grade obtained by the student when taking the Enamed in the sixth year will be recorded in the academic record, and can be used as a criterion for approval in medical residencies that adopt the grade in the selection process.

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Students who do not reach the level of proficiency established by the MEC will not be able to practice Medicine until certification is obtained. There is no limit to participation in new editions of the exam, and students can take the Enamed as many times as necessary until reaching the minimum required performance.

Exam can level the quality of medical courses in Brazil
Faced with a massive growth in medical courses in the country, the quality of medical education is highly heterogeneous. According to data from the Associação Paulista de Medicina (APM), since the 2000s, medical schools have gone from just over 100 to 390 institutions. Among these, more than 80% of these institutions are private, indicating that much of the expansion was led by the private sector. It is estimated that around 175 thousand students are enrolled in private medical courses.

Enamed was initially established as a quality indicator by the MEC. Since its first application, in 2025, of the 351 medical courses that participated in Enamed, 304 belong to the Federal Education System, which includes federal and private institutions, the only group over which the MEC has direct supervisory power.

Among the institutions evaluated, 99 courses (32.6%) were in bands 1 and 2 of the Enade Concept, considered unsatisfactory, as less than 60% of students performed adequately.

For Rômulo Paes de Sousa, president of Abrasco (Brazilian Public Health Association), doctor and PhD in epidemiology from the University of London, the importance of the exam lies in attributing responsibility for training not exclusively to the candidate, but also to those who train it. "It is very positive that we do this (...) that we have, yes, regulatory mechanisms in the training and entry of new professionals", he declared.

According to the doctor, well-established regulatory mechanisms are capable of positively influencing the quality of the courses offered.

"The expectation is that [Enamed] will be positive, especially because it combines the evaluation of the student's performance and that of the faculty", he argues. Rômulo argues that, given the discrepancy in the quality of teaching between institutions, a model that only evaluates the student is limited and does not require curricular and structural improvements from the course.

Registration for the next edition of Enamed and for direct access medical residency vacancies under Enare (National Residency Exam) are now available and can be completed until June 29th. For other residency programs offered by Enare (such as those that require specific prerequisites or multi-professional areas), the deadline extends until July 15th. The Enamed and Enare tests will take place on September 13th.

See the Medicine courses that received the highest score in the MEC evaluation

Source: CNN