The Lula (PT) government plans to carry out technical visits to all Brazilian medical schools in 2026. This examination, together with the results of the recently created Enamed (National Medical Training Assessment Examination), will help assess the quality of courses and may also eliminate vacancies.
This initiative is part of a joint effort by the Ministry of Education and the Ministry of Health. Faculty are seeking to understand the impact of the accelerated growth of medical schools in the country, which began with the Mais Medicos Program in 2013.
Since then, medical school capacity has doubled, from 23,000 in 2014 to more than 50,000 in 2025. This increase is expected to bring the number of doctors in the country to 1.2 million by 2030. This would result in a ratio of 5.3 doctors per 1,000 residents, almost double the current rate of 3 doctors per 1,000.
He emphasizes that the biggest concern for PT managers is this level of training. sheet Felipe Proenzo, Secretary of Labor Management and Health Education; “Beyond measuring quality, governments are interested in how this assessment is carried out,” he says.
One of the proposals being processed in Congress is a national medical proficiency exam known as the “OAB of medicine.” This bill is being advanced with urgency and is supported by organizations such as the CFM (Commonwealth Council for Medical Sciences).
The federal government opposes it. “We understand that we need to facilitate a broad restructuring of medical training, which is why the PL (bill) does not take into account the complexity of the subject matter,” Proenzo says. “Of course we need evaluation, but we need it to impact not only the students but also the institution,” he explains.
The secretary defends the exams, which were conducted procedurally throughout the course. As an example, he cites Enamed.
The test, which was held for the first time on October 19th, involved 92,000 participants, and their results will have a direct impact on educational institutions. Universities with a rating of less than 3 will be subject to supervisory guidance, and universities with a rating of 1 will have their entrance exams for the first half of 2026 canceled.
According to Proenzo, if the quality of medical institutions does not improve, closure of medical courses will be considered. “If an institution achieves a Grade 1 in 2025 and repeats this result in 2026, decisions need to be made about its future.”
Another problem plaguing federal management is the lack of training opportunities for physicians, paralleling the increase in the number of medical courses, making it difficult to train specialists. According to data from USP’s Brazil Medical Demographics, the number of medical students increased by 71% between 2018 and 2024, but the number of residency vacancies increased by only 26%.
The deficit is clear: 16,189 residency positions were opened in 2024, but 27,263 doctors earned degrees in 2023.
During the implementation of Mais Medicos, residency vacancies expanded significantly, but the scenario changed due to administrative decisions. For example, in 2022, no notice was announced for the Pro-Residencia program, which provides scholarships to expand vacancies. “We plan to restart this process in 2023. The strong demand from educational institutions for proposals for training programs shows that we have the ability to expand our offering,” Proenzo informed.
Currently, the government is planning to expand the range of specialized fields and hope to reduce or stabilize the number of faculties in order to achieve this balance.
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