Congress approves mandatory exam for doctors

The Senate passed a law on Thursday that makes the National Medical Education Assessment Examination (ENAMED) mandatory for medical students. The proposal, presented by the federal government in June as medida provisória, needed to be voted on by Congress by Friday to not lose its validity. In the morning, the House of Representatives had already approved the text.

Test in three stages and minimum grade

Among the new rules are the application of the test in three periods of the medical course and the requirement of a minimum grade for the exercise of the profession. The original text of the medida provisória provided for two tests during graduation, but the approved text proposes three stages of evaluation.

The exam will measure the proficiency of medical students and evaluate the undergraduate courses from the average accumulated in the stages, with greater weight for the last evaluation. The source did not detail the exact dates of application of each step.

What is Enamed

The Enamed is an annual test applied since 2025 by the MEC through the National Institute of Educational Studies and Research Anísio Teixeira (Inep) to evaluate medical training in Brazil. Until then, the exam was used to evaluate the quality of medical courses and select candidates for medical residency programs.

Now, it also has the function of verifying that the graduate has achieved the minimum performance considered necessary to act as a doctor. The change represents a new filter for professional exercise.

Rules for those already in the course

The requirement of a proficient level in the final result of the Enamed for the exercise of Medicine does not apply to students who were already enrolled in undergraduate courses in Medicine in Brazil before the publication of the MP. These students will remain subject to the norms in force at the time of their entry into the institution of higher education.

The doctors trained in foreign institutions who have been approved in the first stage of the National Exam of Revalidation of Medical Diplomas Issued by Institution of Foreign Higher Education (Revalida) until the date of publication of the MP will not be submitted to the Enamed. They will remain qualified to perform the clinical skills exam in the next two editions of Revalida.

Consequences for courses and graduates

The undergraduate courses in medicine will receive an annual concept, calculated based on the proportion of students who reach proficient level in the third stage of the Enamed. An unsatisfactory result will lead to the opening of the supervisory process and the application of measures.

Those who complete the course of Medicine and do not obtain a proficient level in the final result of the Enamed may apply to the Regional Council of Medicine (CRM) for the Medical Graduate Registration (IEM), with a restricted validity and exclusively technical-scientific purpose. The IEM is a non-professional registry, with limited functions and without authorization for the practice of private acts of doctors.

The activities should be carried out under the supervision of a regularly enrolled physician or a responsible researcher, without clinical contact with patients. They may also not occupy or replace positions and functions intended for physicians, including administrative, managerial, advisory or leadership in health institutions.

National Evaluation Commission

To accompany the examination, the text proposes the creation of the National Commission for the Evaluation of Medical Training, with a deliberative function and composed of two representatives appointed by the Ministry of Education, two by the Ministry of Health and four by the Federal Council of Medicine (CFM).

The members of the committee will be appointed annually. The presidency shall be exercised for the same period, alternately between the representatives appointed by the Government and the MFF. The National Commission for the Evaluation of Medical Training will have three deliberative technical subcommittees, one for each stage of the examination.

Restrictions for IEM subscribers

Persons enrolled in the IEM are prevented from exercising private acts of doctors, providing assistance or care to patients, drawing up or validating medical records, prescriptions, certificates, reports, opinions and other medical-assistance or expert documents. The measure seeks to ensure that only professionals with proven performance act directly in health care.

With approval in Congress, the text now goes for presidential sanction. The expectation is that the new law will bring significant changes in the training and practice of medicine in the country.

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