PROFIMED: meet the “bar exam” for medicine

On December 3, 2025, the Federal Senate’s Social Affairs Committee (CAS) approved in a first-round vote Bill No. 2,294/2024, which creates the National Medical Proficiency Exam (unofficially called PROFIMED).

The bill amends Law No. 3,268/1957, which governs the Councils of Medicine, and makes passing a national exam a condition for a physician’s registration with the Regional Council of Medicine (CRM).

This model mirrors the exam of the Brazilian Bar Association (OAB), which is mandatory for anyone who wants to practice law.

In this article, learn what PROFIMED is, the reasons for creating this exam, where it stands in the legislative process and how it differs from other exams, such as Revalida.

What PROFIMED is and its legal purpose

The National Medical Proficiency Exam (nicknamed medicine’s “bar exam”) is defined in the bill as a mandatory national exam designed to assess whether medical school graduates meet the minimum requirements to practice the profession.

The assessment must cover professional and ethical competencies, theoretical knowledge and clinical skills, and it takes as its reference the National Curriculum Guidelines (DCN) for medical programs.

The bill’s rationale mentions the growing number of medical programs, the geographic distribution of these schools and the results of assessments given to newly graduated physicians in recent years.

Among the points cited, the text refers to the experience of the Regional Council of Medicine of the State of São Paulo (Cremesp), which began giving proficiency exams to medical graduates in 2005. In 2012, the exam became mandatory to obtain professional registration in the state.

This requirement remained in place until October 2015, when it was suspended by a preliminary injunction issued by the Federal Courts, in a lawsuit filed by the Union of Sponsoring Entities of Higher Education Institutions (Semesp).

Although the exam’s mandatory status changed over that period, the results of the editions held are cited in the bill’s rationale as empirical evidence in the legislative debate.

In 2012, the first year it was mandatory, 54.5% of the 2,411 participants did not reach the minimum required performance. In 2013, the failure rate was 59.2% among 2,843 new graduates. In the 2014 edition, 55% of the 2,891 participants did not reach the minimum passing score. In the following years, the pass rates recorded were 51.9% in 2015, 43.6% in 2016, 64.6% in 2017 and 61.8% in 2018.

If Bill No. 2,294/2024 is approved at every stage, PROFIMED will formally become part of federal law and a legal requirement for obtaining a CRM registration. Completing the undergraduate program will then no longer be enough, on its own, for professional registration: passing the exam will also be required.

Institutional structure and administration of the exam

Under the substitute text approved by the CAS, the national coordination, regulation and organization of the exam will be the responsibility of the Federal Council of Medicine (CFM). Administering the exam, in turn, will fall to the Regional Councils of Medicine, each within its own jurisdiction.

The text requires the exam to be held at least twice a year, in every state and the Federal District, and to include theoretical and practical assessments. The CFM must also set up a Support and Monitoring Committee, with an advisory role, made up of representatives of the Ministry of Education (MEC), the Ministry of Health (MS), the National Medical Residency Committee (CNRM) and medical and scientific organizations.

Individual exam results will be confidential and must be sent to the MEC and the MS for regulation, evaluation of medical programs and the design of public policies on medical education.

Who will be required to take PROFIMED

The exam will be mandatory for medical school graduates, trained in Brazil or abroad, who wish to obtain a CRM registration and who entered their undergraduate program after the law takes effect.

The following are exempt from the exam:

• physicians who already have a CRM registration approved before the rule takes effect;

• students who entered medical programs before the law is published.

The bill provides that the law will take effect one year after its publication, a period set aside for regulating the exam and for the CFM to organize its administration.

PROFIMED, Revalida and Enamed: what are the differences?

Although all three exams are taken by medical students or graduates, they have different purposes and characteristics:

PROFIMED, if finally approved, will be a mandatory exam for obtaining a CRM registration, coordinated by the CFM and designed to assess competencies.

The National Medical Education Assessment Exam (Enamed) focuses on assessing academic training, is coordinated by the Ministry of Education and is taken during medical school. Its focus is monitoring the quality of programs to strengthen education policy, with no direct effect on professional registration.

The National Exam for the Revalidation of Medical Diplomas (Revalida), in turn, is an assessment created by the federal government in 2011, run jointly by the Ministry of Education (MEC) and the Ministry of Health, to evaluate and recognize medical degrees issued by foreign institutions.

Medical Graduate Registration (IEM)

For new graduates who have not yet passed PROFIMED, the bill creates the Medical Graduate Registration (IEM). It is a non-professional registration that does not authorize the practice of medicine.

The IEM does not allow its holder to perform medical acts, care for patients, issue or sign clinical documents or hold positions restricted to physicians. Permitted activities are limited to technical and scientific roles with no patient contact, such as research, teaching, innovation, data analysis and healthcare administration. Once the graduate passes PROFIMED, the IEM is canceled and the full CRM registration is granted.

Where the bill stands

Once voting in the Federal Senate is complete, Bill No. 2,294/2024 will go to the Chamber of Deputies for review. If it is approved without changes, the text will be sent for presidential signature.