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Nov 8, 2026
Brazil ties new doctors’ licenses to national exam scores
Supporters of the measure present it as a safeguard for patients and a response to uneven medical training, while both accounts underscore that the rule is prospective and does not alter the status of already licensed doctors or current students.
President Luiz Inácio Lula da Silva has signed legislation that turns Brazil’s National Medical Training Assessment Exam, or Enamed, into a licensing hurdle for future medical graduates. The measure, often described as an “OAB for Medicine” in reference to the bar examination for lawyers, links professional registration to a minimum level of proficiency.1
The two accounts broadly agree on the mechanics and aim: students entering medical school from June 19, 2026, will face compulsory assessments at the end of their second, fourth and sixth years. Their final result will combine the three tests, with greater weight given to the last one. Graduates who do not meet the required standard may retake the final stage, but cannot treat patients while awaiting certification.2
Lula framed the law as a response to the commercial pressures surrounding medical education. “Medicine has become somewhat commercialized,” he said at the signing ceremony, arguing that better-trained doctors offer greater assurance of longer lives.2 The Brazil Left account places similar emphasis on patient protection, saying the system is intended to uncover gaps in learning before graduates reach clinics, hospitals and public health units.1
The law also extends its focus beyond individual graduates. Medical schools with weak results can face Education Ministry supervision, including reduced enrolment places or suspension of new admissions. One account notes that 99 of 304 federally regulated courses assessed in 2025, or 32.6%, recorded unsatisfactory performance, while former education minister Camilo Santana warned against institutions charging high fees without delivering quality training.1
Neither account describes the change as retroactive. Students enrolled before the cutoff, doctors already holding recognized Brazilian diplomas and foreign-trained doctors subject to the separate Revalida process are not required to take Enamed for continued practice. Graduates who fail the new threshold may still obtain a restricted registration for supervised research and technical-scientific work, but not clinical care, prescriptions or medical certificates.2