news · medical education

March 17, 2026 · bip Insights

MEC applies sanctions to medical courses with low Enamed performance: what changes for students and residents

On March 17, 2026, the Ministry of Education published ordinances in the Official Gazette formalizing sanctions against medical courses with poor performance in Enamed. Understand what the exam is, what the penalties are, and what this means for those currently in medical school or about to enter residency.

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Medical student at a university in Brazil — Enamed and MEC sanctions 2026

What did the MEC announce on March 17, 2026?

The MEC published on Tuesday, March 17, 2026, ordinances in the Official Gazette formalizing sanctions for medical courses with unsatisfactory performance in the 2025 Enamed. The measures move from announcement to implementation: cut in vacancies, suspension of Fies, and in the most severe cases, total blocking of new entrants.

Ordinances SERES/MEC nº 72, 73, 74, 75 and 76, of March 16, 2026, formalize the supervision processes with cautionary measures graduated according to the concept obtained by each course. The affected institutions have 30 days to present their statements and appeal the measures.

"The goal is to ensure well-trained doctors to care for people in hospitals, health posts, and UPAs." — Camilo Santana, Minister of Education

What is Enamed and how does the evaluation work?

Enamed (National Examination for the Evaluation of Medical Training) is the specific version of Enade for medicine, created by the MEC in April 2025 and applied annually by Inep. The exam evaluates 100 objective questions based on the National Curriculum Guidelines and requires mandatory participation from graduating students.

Concept Scale (1 to 5)

Concept 1: less than 40% proficient. Concept 2: between 40% and 59.9%. Concept 3: between 60% and 74.9%. Concept 4: between 75% and 89.9%. Concept 5: above 90% proficient.

2025 Enamed Result

351 courses evaluated, 89,024 participating students. 75% achieved proficiency. 107 courses received concepts 1 or 2 — about 30% of the total. 99 of them, belonging to the Federal Education System, are subject to MEC sanctions.

Inequality between networks

Federal: 83.1% average proficiency. State: 86.6%. Private for-profit: 57.2%. Municipal: 49.7% — with 85% of municipal courses considered unsatisfactory.

What are the MEC sanctions for poorly rated medical courses in Enamed?

The penalties are scaled according to the concept obtained in the exam. The worse the score, the more severe the intervention. See the structure of the sanctions published in March 2026:

Concept 1 — less than 40% proficient

Total suspension of new entrants

Immediate suspension of new student enrollment
Suspension of Fies contracts
Suspension of regulatory benefits and federal programs
8 courses in this situation across Brazil

Concept 2 — between 40% and 59.9% proficient

Vacancy cuts and Fies suspension

13 courses with a 50% reduction in authorized vacancies
33 courses with a 25% reduction in vacancies
45 courses prevented from increasing vacancies
Suspension of Fies and federal programs for all

Duration of measures

Valid until Enamed 2026

Sanctions are valid until the release of the 2026 Enamed results, expected in October
Institutions have 30 days to present their defense and appeal
2026 Enamed results may exacerbate, maintain, or revoke the measures

What changes for students studying at a sanctioned faculty?

The sanctions affect the institution, not already enrolled students. The MEC was explicit: no student currently enrolled will be directly harmed by the measures. But this does not mean that students can be indifferent to what is happening.

Demand an improvement plan
The faculty is obliged to present an action plan to the MEC to improve teaching quality. As a student, you have the right to monitor and demand this process through the academic center.
Consider transferring carefully
Transferring to another faculty is possible, but usually involves a specific selective process and analysis of curriculum compatibility, which can delay your studies. Weigh the pros and cons before deciding.
Invest in your education independently
Your faculty's Enamed score does not determine the score you will get. Consistent study, mock exams, and preparation for Enare are your responsibilities, not the institution's.

How does Enamed affect access to medical residency?

The MEC integrated Enamed into Enare (National Residency Exam), making the exam score relevant for those who want to enter medical residency. This change has a direct impact on the preparation strategy of any student planning to do residency.

4th year score counts towards Enare

The score of 4th-year students in Enamed now accounts for 20% of the Enare score for direct access to medical residency. Those who do well on the exam get a head start in the competition for vacancies.

Mandatory and annual participation

Enamed is applied annually. Starting in 2026, it will evaluate 4th and 6th-year students (pre-internship), creating two monitoring moments throughout their training. Preparing for the exam from the beginning of the course is no longer optional.

Enare's Growth

Enare grew from 92 participating institutions in 2022 to 262 in 2025, with the number of applicants jumping from 27,755 to 87,035 in the same period. The unification with Enamed reinforces the exam's centrality in access to residency.

"The Enamed score now counts for residency. Preparing for the exam is no longer optional."

Why did the MEC need to create Enamed and apply sanctions now?

Brazil experienced accelerated and disordered expansion of medical courses between 2017 and 2022, without continuous quality assessment mechanisms. The result was a growing number of graduates with insufficient training, which concerns both the MEC and the CFM due to its direct relationship with patient safety.

Enamed emerges as a structural response to this problem: an annual, mandatory evaluation with real consequences for institutions. The declared objective of the Ministry of Education and the Ministry of Health is to ensure that doctors trained in Brazil are sufficiently prepared to work safely in hospitals, UPAs, and basic SUS units.

In 2026, in addition to the already published sanctions, Inep will conduct on-site visits to all medical courses in the country, focusing on the development of practical activities and the infrastructure of the institutions.

Frequently asked questions about Enamed and MEC sanctions

Direct answers to the most common questions about the exam, penalties, and impact on medical residency.

What is Enamed? +

Enamed is the National Examination for the Evaluation of Medical Training, created by the MEC in 2025 and applied annually by Inep. It evaluates graduating medical students and determines the quality concept of each course on a scale of 1 to 5. Courses with less than 60% proficiency receive concept 1 or 2 and are subject to sanctions.

What are the penalties for poorly rated courses in Enamed? +

Concept 1: total suspension of new student enrollment and Fies. Concept 2: reduction of 25% or 50% of vacancies, suspension of Fies and federal programs. All affected courses are prevented from increasing vacancies. The measures are valid until October 2026, when they will be evaluated based on the next Enamed.

My university was penalized. What happens to me? +

The penalties affect the institution, not already enrolled students. You will not be directly harmed. However, as a student, you have the right to demand a clear improvement plan for your education from the university. Monitor the process through the academic center and via e-MEC.

Does Enamed affect access to medical residency? +

Yes. The 4th year Enamed score now accounts for 20% of the Enare score for direct access medical residency. The exam's performance is no longer just an institutional evaluation and now directly impacts each student's individual career.

What is the performance difference between public and private universities in Enamed? +

The data reveals a significant difference. Federal universities had an average proficiency of 83.1% and state universities, 86.6%. For-profit private universities recorded 57.2% and municipal universities, only 49.7%, with 85% of municipal courses considered unsatisfactory by the MEC.

When will the next Enamed be? +

The next Enamed is scheduled for October 2026. From this edition onwards, the exam will assess 4th and 6th-year students (pre-internship), extending the monitoring of medical training to two points during the course.