ENARM

Overview

The Examen Nacional de Aspirantes a Residencias Médicas (ENARM) is Mexico's national entrance exam for medical residency training. It is designed and run by the Comisión Interinstitucional para la Formación de Recursos Humanos para la Salud (CIFRHS), a body that brings together the health and education institutions that train and employ physicians in Mexico. The exam ranks newly graduated and practising general physicians so they can be placed into residency programmes (R1, the first year of a specialty) across public hospitals and health institutions nationwide.

ENARM is one of the most competitive medical entrance exams in Latin America. For the 2025 cycle (the 49th edition), around 50,490 physicians sat the exam for 18,515 R1 places available to the Mexican category that year, an acceptance rate of roughly 37% — meaning most candidates who sit the exam in a given year do not get a residency place that cycle. Passing the exam itself is only the first hurdle: a candidate's score also decides which specialty and institution they can realistically choose once the ranked list is published.

Who can apply

ENARM registration is split into two categories:

• Categoría mexicana: for physicians who are Mexican nationals, whether by birth or by naturalization, and who hold a completed Licenciatura en Medicina (general medicine degree).

• Categoría extranjera: for non-Mexican physicians who want to train in Mexico's residency system, within the limited number of places set aside for this category each year.

Document requirements differ by where the degree was earned:

• Physicians who studied in Mexico must present their cédula profesional for general medicine, issued either by the federal Dirección General de Profesiones (Secretaría de Educación Pública) or by the equivalent state education authority. A candidate who does not yet have the cédula may submit the professional título instead, while the cédula is still being processed.

• Physicians who studied abroad (categoría extranjera) must present their foreign título with an apostille obtained from the competent authority in their home country, or a cédula profesional issued by the SEP's Dirección General de Profesiones, together with a valid passport. Degree homologation in Mexico is not required simply to sit the ENARM.

All candidates must also register online, upload a recent passport-style photograph and an official photo ID (INE for Mexican nationals), and complete the registration and payment steps within the windows CIFRHS publishes each year.

Exam pattern

ENARM is a single written exam of 280 multiple-choice items, taken in one sitting: 250 items in Spanish plus 30 items in English that test medical reading comprehension.

Most items are short clinical-case vignettes: the candidate reads a patient's history, exam findings and test results, then picks the best next step, rather than answering an isolated recall question.

Marking and results

Each item carries its own difficulty weight rather than counting equally: CIFRHS reports weighting high-difficulty items at three points, medium-difficulty items at two points, and low-difficulty items at one point, combined into a single weighted score for the candidate.

There is no single pass mark that applies to every candidate. CIFRHS publishes a minimum overall score for the categoría extranjera each cycle by formal agreement (for the 2025 cycle, a score of 43.0000 or higher under Acuerdo 8/3a ORD/2025); the categoría mexicana's minimum is likewise set each cycle by the CIFRHS committee responsible for postgraduate medical education. Clearing the minimum does not guarantee a residency place by itself — it only makes a candidate eligible to be ranked and to take part in the specialty-and-site selection process described below, where each specialty-institution combination has its own effective cutoff score that varies from year to year and place to place.

Important dates

The cycle runs once a year on a calendar CIFRHS publishes with that year's convocatoria; exact dates move from year to year. For the 50th ENARM (2026 cycle):

Candidates should always confirm the current year's dates on the official CIFRHS site, since the registration and exam calendar is republished with each new convocatoria.

Fees

For the 2026 cycle, the ENARM registration fee is 3,300 Mexican pesos (MXN), payable within the deadline set after pre-registration closes. The fee amount and payment deadline are republished with each year's convocatoria.

How to apply

1. Complete online pre-registration on the CIFRHS portal within that year's pre-registration window, choosing a category (mexicana or extranjera).

2. Pay the registration fee by the published deadline.

3. Complete the full online registration: upload the cédula profesional (or título), official photo ID, passport-style photograph and any category-specific documents (apostilled título and valid passport for the categoría extranjera).

4. Wait for CIFRHS to publish the assigned exam venue, date and shift.

5. Sit the exam over the scheduled sitting dates at the assigned venue.

6. Check the published results and overall ranking once released.

After the exam

Once CIFRHS publishes results, every candidate who cleared their category's minimum score is placed on a single ranked list, from the highest score down. Using that order, CIFRHS publishes a specialty-and-site selection guide, and each candidate in turn selects a specialty and institution from the places still open at their turn, choosing from a list that shrinks as higher-ranked candidates make their picks. Because each specialty-institution combination has its own effective cutoff, there is no single national cutoff for a specialty such as pediatría — only a separate cutoff for pediatría at each participating hospital. Since 2025, CIFRHS has run the selection process in four successive rounds (vueltas) rather than one, to give more candidates a chance to be placed as earlier rounds' unfilled or declined places become available again. A candidate's selection, once made, is binding for that specialty and site: changes of specialty or site are not permitted afterward.

Preparation tips

• Prioritise the four core clinical areas — Medicina Interna, Cirugía, Pediatría, and Ginecología y Obstetricia — since together they make up most of the exam, while keeping up public-health, emergency-medicine and family-medicine topics that appear woven into the same case vignettes.

• Practise clinical-case vignettes that ask for the next diagnostic or management step, since this is the dominant question style, rather than relying only on isolated recall review.

• Do not skip English-language practice: 30 of the 280 items are medical reading-comprehension questions in English.

• Review official past-year guides and item banks where available, since question style and emphasis are reasonably stable from one convocatoria to the next.

• Plan residency and site preferences realistically before results are published: because every specialty-institution pair has its own cutoff, a strong overall score can still fall short of a specific, highly competitive combination.

FAQs