On April 23, 2025, the Brazilian Ministry of Education (MEC) announced a significant new initiative aimed at improving medical education in the country. The Exame Nacional de Avaliação da Formação Médica (Enamed) will be a mandatory annual assessment for all graduating medical students, with the first test scheduled for October 2025. This exam is designed not only to evaluate the quality of medical training across Brazil but also to serve as a selection tool for medical residency programs.
The Enamed will consist of 100 multiple-choice questions covering a range of subjects, including Clinical Medicine, General Surgery, Gynecology and Obstetrics, Pediatrics, Family and Community Medicine, Mental Health, and Collective Health. The exam is expected to involve approximately 42,000 graduating students, as well as already graduated doctors who wish to apply for residency positions through the Exame Nacional de Residência Médica (Enare).
Enrollment for the Enamed will open in July 2025, and the results are anticipated to be released in December. This new examination will be produced by the Instituto Nacional de Estudos e Pesquisas Educacionais Anísio Teixeira (Inep) in collaboration with the Empresa Brasileira de Serviços Hospitalares (Ebserh).
Minister of Education Camilo Santana emphasized the importance of the Enamed during the announcement, stating that it aims to enhance the quality of medical training in Brazil. "The Enamed points to what needs to be observed, which are the educational institutions. It is not the student who is responsible for their training, but the institution," he said. This statement underscores a growing concern regarding the quality of education provided by many medical schools, particularly private institutions, where a significant portion of the medical training takes place.
In 2023, the results from the Exame Nacional de Desempenho dos Estudantes (Enade) revealed troubling statistics, with 27.3% of medical courses in private colleges receiving low scores, compared to just 6% in public universities. Out of 31,000 graduates assessed from 309 medical programs, 190 were from private institutions, and 52 received the lowest ratings.
Camilo Santana has been vocal about the need for reform in the medical education sector, proposing the establishment of the Instituto de Regulação da Educação Superior do Brasil to monitor and regulate tuition fees at medical schools. This initiative aims to address disparities in tuition costs and ensure that all institutions maintain a high standard of education.
Alongside him, Minister of Health Alexandre Padilha also addressed the need for quality improvements in medical training, particularly in light of the increasing number of medical schools in Brazil. "We need to ensure that future doctors are well-prepared to work effectively within the Sistema Único de Saúde (SUS)," he stated, highlighting the direct impact of medical education on public health services.
The Enamed is seen as a pivotal step towards establishing a more standardized and transparent evaluation process for medical education in Brazil. It will help align the assessment of medical training with the competencies required by the Diretrizes Curriculares Nacionais (National Curriculum Guidelines) and provide essential data to improve medical courses.
In addition to evaluating the knowledge and skills of graduating students, the Enamed will also facilitate the selection process for residency programs. By integrating the evaluation criteria of the Enade and the Enare, the government aims to streamline the pathway for medical graduates entering residency, thereby enhancing the overall quality of healthcare professionals in Brazil.
As the first Enamed approaches, educational institutions and students alike are preparing for this new challenge. The mandatory nature of the exam for all graduating medical students marks a significant shift in how medical education is assessed in Brazil. With the stakes higher than ever, the focus will be on ensuring that graduates possess the necessary competencies to meet the demands of modern healthcare.
The introduction of the Enamed is not without its critics. Some stakeholders, particularly from private institutions, have expressed concerns that such standardized testing could create barriers to entry into the medical profession. However, proponents argue that the exam is essential for raising educational standards and ensuring that all medical graduates are adequately prepared for the challenges they will face in their careers.
As Brazil continues to navigate the complexities of medical education reform, the Enamed will play a crucial role in shaping the future of healthcare professionals in the country. The government is committed to fostering an environment that prioritizes quality education and, ultimately, better health outcomes for all Brazilians.
In summary, the Enamed represents a significant advancement in Brazil's approach to medical education. By establishing a standardized assessment for all medical graduates, the MEC aims to enhance the quality of training, support the improvement of medical courses, and strengthen the nation's healthcare system.
