Peru's faculty-run national exams: ENAM for doctors and its siblings

Medical and health education in Peru

Medicine in Peru is a seven-year degree, usually six years of study followed by a one-year hospital internship (internado), taught in Spanish at about forty universities. SUNEDU licenses universities, and SINEACE handles programme accreditation. Dentistry, pharmacy and nursing are generally five-year degrees. Faculty bodies, including ASPEFAM, the association of medical faculties, are active in shaping the curriculum and the national exam.

After graduation, doctors register with the Colegio Médico del Perú (CMP), which is required for practising. The next step for most is SERUMS, a year of rural and urban-marginal health service run by the Ministry of Health, which is a condition for many public posts and residency places. The national medicine exam, ENAM, is run with ASPEFAM, and its scores are used for ranking and placement, not as a licence. Specialty training is entered through a competitive residency admission. The rules change often, so confirm the current ENAM and SERUMS requirements with the Ministry of Health.

Exams run by the faculties, scores used by the state

What sets Peru apart is who owns the exams. ENAM is run by ASPEFAM, the association of Peruvian medical faculties. The nursing exam is run by ASPEFEEN, the association of nursing faculties and schools. The pharmacy exam was made official through a legal norm published in El Peruano. These bodies are academic, not regulators in the usual sense, yet the state relies on their results: the score counts for SERUMS (Servicio Rural y Urbano Marginal de Salud), the service period that opens public-sector posts, and for admission to national residency through the Sistema Nacional de Residentado Médico.

The effect is a layered system. First the degree. Then a national exam. Then service. Then, for doctors, a competitive residency exam.

Who needs a licensing exam in Peru

Doctors: ENAM

Format. 180 multiple-choice questions with four options each. Around 90% are clinical cases. There is no penalty for wrong answers, so every question should be answered. The pass mark is 11 out of 20. The bases (rules) for each sitting are published as a PDF by ASPEFAM, and there are ordinary and extraordinary sittings each year.

Who sits it. Peruvian graduates and bachelors, and foreign-licensed doctors who have not yet been examined. Retakes are allowed. Because the result feeds SERUMS and residency rankings, many candidates retake it to improve their score even after passing.

1. Read the bases for the sitting published by ASPEFAM for dates, fees and eligibility.
2. Register within the stated period and keep the confirmation.
3. Sit ENAM in the 3-hour session.
4. Use the result for SERUMS allocation and residency applications.
5. For specialty training, register for the Examen Nacional de Residentado Médico run by CONAREME.

How to approach a 180-question clinical-case exam

ENAM is long, and its cases are the reason. With about 90% of questions framed as clinical cases, recalling isolated facts is not enough. You need to read a vignette, identify the problem, and pick the next step, the diagnosis or the treatment. Three minutes of reading for each question would use up the whole 3 hours, so speed in parsing the case matters as much as knowledge.

• Build a rhythm of about one minute per question, marking harder items for a second pass.
• Answer everything, because wrong answers are not penalised.
• Study Peruvian MINSA clinical guides and national health priorities alongside international textbooks. Tuberculosis, dengue, anaemia in children and maternal health feature heavily in local training.
• Do full-length timed practice at least three times before the sitting.

Because the score counts for SERUMS allocation and for residency ranking, the exam works as both a gate and a ranking. A pass at 11 is enough to clear it; a higher score improves your options afterwards.

Nurses and pharmacists

The Examen Nacional de Enfermería (ENAE) is run by ASPEFEEN, and its score is used for SERUMS. The Examen Nacional de Farmacia y Bioquímica (ENAFB) is run by the pharmacy faculties and is officialised by a norm in El Peruano. Both are multiple-choice. We could not verify the number of items or the pass mark for either, so check the bases for each sitting.

Midwives, dentists and physiotherapists

Peru has national exams for several SERUMS professions, including obstetricia (midwifery) and odontología (dentistry), but we have not been able to verify their current status, format or organiser. For physiotherapy the position is also unconfirmed. If you work in one of these fields, ask your professional college (Colegio de Obstetras, Colegio Odontológico, Colegio de Tecnólogos Médicos) before assuming that no exam applies.

Foreign-trained candidates and language

Foreign graduates must have their degree recognised or revalidated by SUNEDU, the higher-education regulator, before professional registration. The bases for ENAM mention foreign-licensed doctors who have not yet been examined, so there is a route to sit it. Spanish is required. For Venezuelan and other Latin American doctors, ENAM is one of several national exams studied in parallel with EUNACOM in Chile and CACES in Ecuador.

Exam comparison

Where to check the rules

The ASPEFAM bases for the current sitting are the authoritative rules for ENAM. The El Peruano norm covers ENAFB. TriagePass is independent of these bodies.

Last reviewed October 2026