On April 23, 2025, the Brazilian Ministry of Education (MEC) officially launched the National Examination for Medical Training Evaluation (Enamed), a significant initiative aimed at enhancing the quality of medical education in Brazil. This new assessment tool is designed to provide a unified evaluation of medical training across the country and will also serve as a gateway for students seeking admission to medical residency programs.
The Enamed is set to replace the National Student Performance Examination (Enade) for medical courses, expanding its scope from 40 to 100 multiple-choice questions covering essential areas of medicine, including gynecology, pediatrics, clinical medicine, surgical clinic, and family medicine. This change reflects a broader effort to ensure that graduating medical students possess the necessary skills and knowledge as they enter the healthcare workforce.
During the launch ceremony, Education Minister Camilo Santana emphasized the strategic importance of Enamed for the Brazilian healthcare system, stating, “The doctor treats life. We know the importance of the doctor, the health professional, and the health care of the population. We want to ensure, and this is a directive from President Lula, the good training of our health professionals.” Santana announced that a working group would be formed to discuss the proposal and format of the examination, involving various stakeholders, including professional councils and educational institutions.
Health Minister Alexandre Padilha highlighted the necessity of ongoing evaluations throughout medical education, rather than only at the end of training. He noted, “It allows us to assess the progress of the student and shed light on the training institution.” Padilha stressed that many medical programs charge substantial tuition fees, which necessitates scrutiny of the quality of education provided.
The objectives of Enamed are multifaceted. It aims to:
- Evaluate medical training to ensure graduates meet the competencies outlined in the National Curriculum Guidelines (DCNs).
- Support the improvement of medical courses by providing data for enhancing medical education quality in Brazil.
- Enhance selection processes for medical residencies by unifying the evaluation of Enade and the objective test for direct access to medical residency programs (Enare).
- Strengthen the Unified Health System (SUS) by ensuring future doctors are well-prepared for public healthcare roles.
- Create a standardized evaluation model to democratize access to medical residency programs.
Enamed will be conducted annually, with the first examination scheduled for October 2025. Registrations are expected to open in July, and individual results will be released in December. Approximately 42,000 medical students are anticipated to participate in the inaugural test, which will be administered in 200 municipalities across Brazil.
The new examination will not only serve as a tool for evaluating medical education but will also be critical for students aiming for residency positions. The Enamed score will be used for direct access vacancies in residency programs, which constitute 91% of available positions in the Enare. Arthur Chioro, president of the Brazilian Hospital Services Company (Ebserh), explained, “The candidate who scores highest on the Enamed will be able to choose their residency position in any institution offering vacancies through Enare.”
In addition to the Enamed, Minister Santana announced plans for a mid-course evaluation, referred to as a progress exam, which will assess students' advancement during their medical education. This initiative aims to identify educational gaps and allow for timely corrections in training programs.
As the MEC moves forward with these reforms, it faces challenges related to the proliferation of medical courses in Brazil. Many new programs have emerged without adhering to established guidelines, leading to concerns about the quality of education. Santana noted that only 7% of the 60,000 new medical course openings have been authorized under the criteria set forth by the federal government.
The introduction of Enamed is part of a broader strategy to ensure that Brazil's healthcare system is staffed by well-trained professionals capable of meeting the needs of the population. The MEC aims to establish a robust evaluation system that not only assesses students' knowledge but also enhances the overall quality of medical education.
As the country prepares for the first administration of the Enamed, stakeholders from various sectors are hopeful that this initiative will lead to significant improvements in medical training and, consequently, in the quality of healthcare provided to the Brazilian populace.
