Medical Residency Under Fire: CFM Takes Quotas to Court in Battle for Merit-Based Selection

The Federal Council of Medicine (CFM) filed a public civil case against the Brazilian Hospital Services Company (Ebserh) for reserving 30% of vacant places (quotas) for vulnerable population groups – such as people with disabilities, indigenous people, black people . and residents in quilombos – in the classification of places for those who are approved in the National Residence Examination (Enare). The case is taking place in the 3rd Civil Court of Brazil, in the Court of Justice of the District and Federal Territories (TJDFT).

The Enare competition took place on October 20th in 60 cities, offering 4,854 vacant medical residency places and a further 3,789 multi-professional residency places in hospitals and other health professional areas. Vacancies will be opened in 163 institutions across the country. Of the 89,000 registered candidates, around 80,000 attended the test sites.

In a note, the CFM describes that the quotas will encourage “the idea of ​​unjustified advantages within the medical profession” and that “this mechanism will create reverse discrimination.” The council recommends that selection for medical residency should be based “on academic merit of knowledge.” Despite the criticism, the CFM “recognizes the importance of positive policies for implementing the principle of fairness.”

The Brazilian Medical Association (AMB) also expressed opposition to the quota criteria for medical residency. “It is necessary to understand that everyone who will take the specialist test has already graduated from the medical course, on an equal basis, assessing the connection.

In response, Ebserh “expresses deep disagreement with published notes that question the inclusion of positive policies in Enare’s notices.” The company remembers that the law provides for the reservation of empty seats, as was done in Enare, and there is support from the Federal Supreme Court (STF) for the “ethnic-racial criteria when choosing access to higher education public.”

Ebserh, created in 2011, is a state-owned company linked to the Ministry of Education, which manages 45 federal university hospitals. According to the state-owned company, Enare’s rules aim to “ensure that access to residency programs reflects Brazil’s demographic diversity and contributes to a more inclusive and equitable health system.”

The Consultative Council of the Oswaldo Cruz Foundation (Fiocruz) expressed support for Enare’s criteria that follow affirmative action. “Access to various post-graduate courses, including health residencies, is still highly unequal, with black (black and brown), indigenous people and people with disabilities under-represented”, points out the note

When choosing Enare for the medical field, the participant indicates the specialty he wishes to reside in and after testing, chooses the hospital he wishes to work in according to the score achieved – a similar system to the National Secondary School Examination system (Enem) and the Unified Selection System (Sisu).

For multi-professional vacancies in hospitals and other health professionals, the participant indicates the profession they are competing for when registering and after the test results, they indicate where they want to work, also according to the score achieved.

Enare written exam results will be released on December 20th. On January 7th next year, the results of the curriculum analysis will be published. The grades define who will fill the available vacancies. From January 21, calls will start. There are three calls in progress. This page contains the candidate’s area with the objective test answer sheets and the platform to submit appeals against the assessment questions.