'OAB of Medicine': Congressional Commission approves mandatory test for doctors

A mixed committee of the National Congress approved this Thursday (15) the opinion of a provisional measure that makes the National Medical Training Assessment Exam (Enamed) mandatory for medical students.

The text has until this Friday (16) to be voted on in the plenary sessions of the Chamber of Deputies and the Senate. Otherwise, the provisional measure loses its validity.

The approved opinion is from deputy Doutor Luizinho (PP-RJ), rapporteur of the proposal. The provisional measure that established the exam was published by the government in June.

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.

The exam will assess the proficiency of medical students and evaluate undergraduate courses based on the average accumulated in the stages, with greater weight for the last evaluation.

The original text of the provisional measure provided for two tests during graduation. The approved text, however, proposes three evaluation stages, carried out:

at the end of the fourth semester;

at the end of the eighth semester, before the student enters the internship;

at the end of the twelfth semester.

The approval criteria and the level of performance required will still be defined by a responsible committee. Participants who do not obtain a proficient level after the final Enamed result will be able to retake the third stage of the exam in other editions.

Doctors who graduated with a nationally recognized diploma and obtained before the publication of the provisional measure, on June 19, 2026, will not be subject to Enamed.

Doctors trained in foreign institutions who have passed the first stage of the National Exam for the Revalidation of Medical Diplomas Issued by a Foreign Higher Education Institution (Revalidated) by the date of publication of the MP will also not be subject to Enamed. They will remain eligible to take the clinical skills exam in the following two editions of Revalida.

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

The individual score obtained in the final result by the participant who reaches a proficient level on Enamed may also be used in the selection process for direct entry into medical residency programs.

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

Registration for medical graduates

Graduates of the Medicine course who do not obtain a proficient level in the final Enamed result may request a Medical Graduate Registration (IEM) from the regional medical council (CRM), with restricted validity and exclusively technical-scientific purposes.

The IEM is a non-professional registry, with limited functions and without authorization for the practice of private acts by doctors.

With registration, registrants will be able to act as assistants or monitors in scientific research, assist in analysis and technical consultancy in health, without issuing assistance opinions, and collaborate in innovation activities, public policies and health technology, among other activities.

The activities must be carried out under the supervision of a regularly registered doctor or responsible researcher, without clinical contact with patients.

People registered with the IEM are prevented from carrying out private acts as doctors, providing assistance or care to patients, preparing or validating medical records, prescriptions, certificates, reports, opinions and other medical-assistance or expert documents.

They may not occupy or replace positions and functions intended for doctors, including those of an administrative, managerial, consultative or leadership nature in health institutions.

Once the proficient level in Enamed has been obtained, the IEM will be canceled when the professional registers in the CRM.

Medical Training Assessment Committee

To monitor the exam, the text proposes the creation of the National Commission for the Assessment 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).

Committee members will be appointed annually. The presidency will be held for the same period, alternating between representatives appointed by the government and by the CFM.

The National Medical Training Assessment Commission will have three deliberative technical subcommittees, one for each stage of the exam.

The committee's responsibilities include:

establish Enamed's general guidelines, including evaluation objectives, general reference matrices, general proficiency criteria and methodological and operational parameters;

define the technical criteria for the preparation, application and operationalization of the exam;

monitor the implementation of Enamed and periodically evaluate its results;

establish criteria and procedures to certify the achievement of a proficient level and securely transmit the information necessary for applications for registration with regional medical councils.