The Federal Council of Medicine (CFM), the body that oversees medical practice in Brazil, is behind more than 80% of the amendments filed in Congress to the provisional measure that makes passing the Enamed, a national exam created by the Lula administration to assess medical training, a requirement for the professional registration of new doctors. According to a survey by the Painel column in the newspaper Folha de S.Paulo, 389 of the 479 amendments filed by deputies and senators draw on suggestions linked to the entity, which opposes the government's model.
Signed by President Luiz Inácio Lula da Silva and published on June 19, provisional measure MP 1.370/2026 applies to students who enter medical school from that date on; those already enrolled or already graduated remain under the current rules. In Brazil, a provisional measure is issued by the president and takes effect immediately, but expires unless Congress approves it. The text also makes the Enamed the theoretical stage of the Revalida, the process that validates diplomas of physicians trained abroad. The joint congressional committee reviewing the measure was installed on August 12, with representative Doutor Luizinho (PP-RJ) as rapporteur. The Chamber of Deputies and the Senate must approve the text by October for it to remain in force.
Among the proposals filed within the congressional deadline, which ended in June, are the addition of a practical clinical skills test, broader participation of medical entities in running the exam, changes to professional registration rules, mechanisms to make results more transparent, closer supervision of medical schools and integration of the Enamed into residency selection, Folha reported. The rapporteur will decide which suggestions make it into his report.
The CFM openly criticizes the measure. The entity's president, José Hiran Gallo, argues the exam does not measure a physician's proficiency, delays any practical effect of the assessment by six years and does not hold schools accountable for poor training. "The measure does not assess medical proficiency. The model has failed under the Education Ministry's oversight," he said in a June statement. The council instead defends ProfiMed (National Medical Proficiency Exam), provided for in bill PL 2.294/2024 and already approved by Senate committees, and cites a Datafolha poll in which 96% of Brazilians said doctors should be tested before receiving their license.
The dispute gained weight with the results of the first edition of the Enamed, created by the Education Ministry in 2025 and administered by Inep, the federal education assessment institute. Of the 351 medical programs evaluated, 107 received the two lowest scores on a five-level scale, most of them at private institutions, while 49 earned the top mark, concentrated in public universities. About 13,000 graduating students fell short of the expected proficiency level, according to the Brazilian Medical Association (AMB); the CFM puts the figure at around 14,000 students at the two lowest levels. Ministry sanctions against 99 programs were suspended in August by an injunction from a federal appeals court, issued at the request of private higher education groups. The government said it will appeal, and the ruling does not affect this year's exam. The AMB backs the assessment: "A diploma cannot be just a piece of paper proving that someone attended a college for six years. It has to represent knowledge, competence and responsibility," said the association's acting president, Luciana Rodrigues Silva.
What is confirmed and what still depends on Congress
Confirmed: the 2026 exam is on and will be administered on September 13, from 1:30 p.m. to 6:30 p.m. (Brasília time), in every state and in the Federal District, with 100 multiple-choice questions. The confirmation card with the test location is available from September 4 on Inep's website, and results for graduating students and graduates are due on December 4. Still pending: the registration requirement only takes effect if Congress approves the measure, and it would apply only to students who started medical school after June 19, 2026. If the text becomes law, the exam will be held twice a year from 2027, and candidates who miss the minimum score may retake it as many times as needed. Until then, students already enrolled follow the current registration rules of the regional medical councils.