Peruvian medical residency selection: a portrayal of scores, distribution, and predictors of 28,872 applicants between 2019 and 2023

Background: Residency selection is crucial for enhancing the healthcare workforce. Most research on this topic arises from the global north, leaving a gap from the global south perspective. Hence, this study aimed to evaluate factors associated with the Peruvian National Residency Examination (ENARM) in Peruvian applicants. Methods: A repeated cross-sectional analytical study was conducted using data from applicants to the Peruvian ENARM from 2019 to 2023. The data were sourced from the National Council of Medical Residency’s webpage and analyzed using descriptive statistics and linear mixed-effect models. Results: The final population consisted of 28,872 (95.06%) of applicants between 2019 and 2023. The mean ENARM score was 11.69, with a pass rate of 61.6% if a standard setting was set at 11. The highest scores were seen in those who achieved scores above 13 in the ENAM and received honors in medical school, while the lowest in those who applied in the captive modality and did not take the ENAM. Most applicants were concentrated in Lima and applied to Surgery, Pediatrics, and Obstetric-Gynecology. The ENAM score was positively associated with the ENARM in the mixed model when adjusting for receiving, year, setting of application, modality, and application specialty. Conclusions: ENAM scores and honors in medical school were most associated with ENARM; hypothetically, 4 out of 10 applicants would fail the ENARM. Moreover, we portrayed the disparities in Peruvian medical education that point toward the quality of medical education, its centralization in the Peruvian capital, and the power dynamics between specialties.