Brazil Congress approves mandatory Enamed exam for medical registration

The Brazilian National Congress has approved Provisional Measure 1370/26, which establishes the National Medical Training Evaluation Exam (Enamed) as a mandatory requirement for obtaining professional medical registration. The measure, which now awaits presidential sanction, will apply to students enrolling in medical courses starting June 19, 2026.

Under the new rules, students will undergo three mandatory evaluations during their degree: at the end of the second, fourth, and sixth years. Professional registration will be contingent upon achieving a minimum proficiency level, calculated via a weighted average of these three stages, with the final exam carrying the most weight.

Those who complete their studies without reaching the required proficiency may apply for a restricted 'Medical Graduate Registration' (IEM). This status allows for technical and scientific activities, such as research, but strictly prohibits clinical practice, prescriptions, or patient consultations.

The Ministry of Education (MEC) will administer the exams. Additionally, the legislation introduces mechanisms to evaluate medical schools based on student performance and establishes guidelines for the use of the Unified Health System (SUS) during practical training, requiring institutions to provide financial or structural contributions to the system.