Inequalities in medical specialization in Mexico: Analysis of the National Residency Examination and accreditation

Abstract

Objective: To evaluate the likelihood of admission to a medical specialty through the National Medical Residency Examination (ENARM), with quality assurance from the Mexican Council for the Accreditation of Medical Education (COMAEM), comparing public and private medical schools. Materials and methods: A study was carried out with a quantitative, documentary, observational and cross-sectional approach, based on the secondary analysis of public and open access information. The probabilities of physicians gaining admission to a specialty were analyzed based on qualification quartiles from the national evaluation and the type of medical school (public or private). Comparisons were made between public and private schools, considering their accreditation status.

Results: A select group of prestigious, high-tuition private schools consistently ranked higher for admission to medical specialties. In contrast, many private schools achieved the lowest scores in the national ranking. Public schools demonstrated greater consistency, with those holding satisfactory accreditation status achieving the highest overall ratings across the cohort. The distribution of state-level educational offerings revealed inequities, reflecting known economic, social, and cultural disparities in Mexico.

Conclusions: Inequities in access to quality medical education during undergraduate training in Mexico require urgent analysis and action. These disparities can negatively impact the fundamental right to health and hinder the development of a high-quality national health system.

Key words: Education, Medical; Right to Health; Health Inequities; Schools, Medical; Mexico.