Lula makes medical licensing exam a gateway to practice

Lula makes medical licensing exam a gateway to practice
President Luiz Inácio Lula da Silva has signed legislation making minimum performance on Brazil’s National Medical Training Assessment Exam, or Enamed, a requirement for professional registration for future medical graduates. The measure, which had been operating under a provisional decree since June, gives the examination a permanent role beyond assessing medical schools.

Accounts from across the political spectrum broadly agree on the practical change: students covered by the law will be assessed at the end of their second, fourth and sixth years, with the final test carrying greater weight in the cumulative score. Those who do not meet the required standard cannot obtain full registration to treat patients, though they may retake the final stage in later editions.

The government’s case centres on standards, patient care and oversight. Lula argued that medicine had become “somewhat commercialised” and said a more human-centred approach was needed; he also maintained that better-qualified doctors give people greater assurance that they will live longer. Education Minister Leonardo Barchini said the results would also support “clearer, more transparent, more efficient and more effective” regulation of higher education.

The right-leaning account places greater emphasis on the restriction imposed on unsuccessful graduates, describing Enamed as the “OAB of Medicine” — a reference to Brazil’s bar examination. It notes that graduates without the required proficiency may receive an egress registration for supervised technical-scientific or research work, but cannot see patients, prescribe medication, issue medical reports or occupy posts reserved for physicians.

Both accounts also underline that the exam will be used to judge medical schools. Institutions with weak results may face reduced places or a suspension of new admissions, with the Education Ministry expected to publish results by institution.

The requirement does not apply to doctors who had already completed recognised Brazilian degrees before the provisional measure was issued, while specified overseas graduates are also exempt under transition rules.

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