ORIGINAL RESEARCH article
Front. Med.
Sec. Healthcare Professions Education
Volume 12 - 2025 | doi: 10.3389/fmed.2025.1679924
Evaluating Medical Education in Brazil: Analysis of the National Student Performance Exam (ENADE) 2023
Provisionally accepted
Rogerio Rufino1*
Alberto Schanaider2
Adauto Dutra Moraes Barbosa3Andrea Povedano4
Mario Fritsch Toros Neves5- 1Department of Thoracic Diseases, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
- 2Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
- 3Universidade Federal Fluminense, Niterói, Brazil
- 4Universidade Federal do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
- 5Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
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Background: The evaluation of medical education in Brazil relies on instruments such as the National Student Performance Exam (ENADE) and the Preliminary Course Concept (PCC), which guide regulation and funding. Objectives: To analyze national data from the 2023 ENADE for the medical program, describing variations by administrative category and region, and to discuss implications for building a fairer assessment model aligned with the principles of the Brazilian Unified Health System (SUS). Methods: A descriptive study using consolidated data from 309 Medical Programs participating in ENADE 2023. Mean scores and standard deviations for the continuous PCC (scale 0-5) were calculated by institutional category (federal, state, municipal public institutions, and private with or without profit) and geographic region. Results: Federal public institutions showed a mean PCC of 2.82 ± 0.38; state, 2.74 ± 0.42; and municipal, 2.65 ± 0.45. Private for-profit institutions had 2.72 ± 0.48, and non-profit institutions 2.85 ± 0.42. The Indicator of Difference Between Observed and Expected Performance (IDOEP) component, which accounts for 35% of the PCC, was higher in for-profit private institutions (3.70 ± 0.68) compared to public ones (2.65 ± 0.50), reflecting limitations in adjusting for socioeconomic intake profiles. Student perception scores were also higher in private institutions (3.85 ± 0.60) than in public ones (3.00 ± 0.55). Regionally, PCC means were higher in the South (3.45 ± 0.40) and Southeast (3.35 ± 0.45) than in the Northeast (2.85 ± 0.55) and North (2.70 ± 0.60). Conclusions: Results suggest that the current ENADE/PCC model may mask structural and regional inequalities, favoring institutional strategies focused on large-scale enrollment with lower admission requirements.
Keywords: educational assessment, Medical Education, Public Policy, Regional inequalities, ENADE
Received: 05 Aug 2025; Accepted: 22 Sep 2025.
Copyright: © 2025 Rufino, Schanaider, Barbosa, Povedano and Neves. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Rogerio Rufino, rrufino.uerj@gmail.com
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