Practising in Brazil: Revalida, CRM and council registration

Medical and health education in Brazil

Medicine in Brazil is a six-year degree (graduação), and the last two years are a compulsory clinical internship (internato). Brazil has among the largest numbers of medical schools in the world, now well above 400, nearly all teaching in Portuguese. The Ministry of Education (MEC) authorises and evaluates courses through its national higher education evaluation system, with INEP running the assessments. Dentistry, pharmacy and nursing are typically five-year degrees.

For Brazilian graduates there has so far been no licensing exam: the diploma allows registration with the regional medical council (CRM) under the Federal Council of Medicine (CFM). A national assessment of medical education, ENAMED, was introduced in 2025 and is linked to residency access, so confirm with MEC and INEP how it affects registration. The exam that matters for outsiders is Revalida, which is for doctors with a foreign degree. After graduation, many doctors apply for medical residency (2 to 5 years), which is competitive and mostly run by state and hospital selection processes. Nurses register with their regional council, COREN, under COFEN.

What makes Brazil different

Brazil is a federal country with a single, very large licensing gate for one group: foreign-trained doctors. Revalida (Exame Nacional de Revalidação de Diplomas Médicos Expedidos por Instituição de Educação Superior Estrangeira) is the exam that decides whether a diploma earned in Bolivia, Paraguay, Argentina, Cuba, Venezuela or elsewhere is accepted. For everyone else the system is administrative. You hold a recognised degree, you register with your council, and you may practise.

That produces an unusual split. Brazilian medical graduates face competitive residency exams but no pass-or-fail licensing test. Foreign-trained doctors face a national, two-stage exam with an interview-style clinical stage. For exam preparation, the written part of Revalida and the residency exams are where multiple-choice practice matters.

Who needs a licensing exam in Brazil

Doctors: Revalida

Revalida is organised by INEP (Instituto Nacional de Estudos e Pesquisas Educacionais Anísio Teixeira), part of the Ministry of Education. Registration afterwards is handled by the CRM in the state where you will work, under the Conselho Federal de Medicina.

Format. Stage 1 is a written test of 100 multiple-choice questions with four options. Stage 2 is a clinical skills assessment in an OSCE format, taken only by candidates who passed Stage 1. A Stage 1 pass is valid for the next two editions, which matters if you cannot get a place at the practical stage straight away.

Eligibility. The call for each edition (edital) sets the rules, and they change. In general, you need a medical diploma from a foreign institution, Portuguese-language ability sufficient for the exam, and documents identifying you and your degree. Brazilians who studied in neighbouring countries make up a large share of candidates, alongside Cubans and Venezuelans.

1. Read the current edital. It fixes the dates, fees, document list and syllabus for that edition.
2. Register through the INEP system within the registration window and pay the fee if one applies.
3. Sit Stage 1, the 100-question written test.
4. Sit Stage 2, the clinical skills assessment, if you passed.
5. Apply to the CRM of the state where you will work, with the Revalida certificate and your documents.

Doctors trained in Brazil: ENAMED, ENARE and residency

A Brazilian graduate does not need to pass a licensing exam to register with the CRM. The exams that shape a young doctor's career come later. ENAMED is the national medical graduate exam, and ENARE is the national residency exam run with EBSERH. Many universities and hospital systems also run their own residency tests, such as those of USP and the São Paulo state health service. A proficiency exam for graduates has been debated in Congress, so check the current position before assuming that none exists. Treat details of ENAMED and ENARE as items to confirm with INEP and EBSERH, because we have not verified their current formats here.

Nurses, midwives, pharmacists, dentists and physiotherapists

None of these professions has a licensing exam in Brazil. Registration follows the degree: COFEN and the regional COREN for nurses and for nurse-midwives (enfermeiras obstetras), CFF and CRF for pharmacists, CFO and CRO for dentists, and COFFITO and CREFITO for physiotherapists. If you trained abroad, the step that stands between you and registration is revalidation of the diploma at a public university, handled through the federal Carolina Bori platform. Universities set their own assessments, which can include written tests, so ask the university you apply to what it requires. Council rules on documents differ by state.

Because these five professions have no national exam to prepare for, the useful work is on the paperwork side: certified translations, legalised documents and the university's own assessment. Start that early, since document processing is usually the slowest step.

Language

All of this is in Portuguese: the edital, the exam, the clinical stage and the council paperwork. Spanish speakers often read Portuguese well enough to follow the text, but clinical questions use fine distinctions in wording, and the OSCE is spoken. Plan time for medical Portuguese before you register.

Exam comparison

Where to check the rules

The edital is the only authoritative statement of how Revalida works in a given year. Start with the INEP Revalida page and the Ministry of Education page for the Carolina Bori platform. TriagePass is independent of INEP, the CFM and the councils, and nothing here is regulator advice.

Last reviewed October 2026