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100+ Free TECM Clínica Médica Practice Questions

Prepare for the TECM — Título de Especialista em Clínica Médica (SBCM, Brazil) exam with instant access — no signup required.

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2026 Statistics

Key Facts: TECM Clínica Médica Exam

Edital nº 2473/2026

Governing Examination Edital (Edital Oficial SBCM / AMB)

SBCM / AMB Official Notice

3 Stages

Assessed Examination Stages (Teórica, Análise Curricular, Prática)

Edital nº 2473/2026

120 Items

Five-option objective questions on the official Prova Teórica

Edital nº 2473/2026 — SBCM

70% / 7 of 10

Minimum for the 1ª Fase combined score, and minimum on the two-station Prova Prática

Edital nº 2473/2026 — SBCM

R$ 750 – R$ 4.500

Registration fee band by membership and candidate category

Edital nº 2473/2026 — SBCM

10 Clinical Domains

Core Internal Medicine Specialty Areas Assessed

SBCM Syllabus

2-Year Residency / 4-Year Practice

Eligibility Prerequisite (Residência CNRM ou Tempo de Atuação)

Edital nº 2473/2026

RQE / CFM

Official Specialist Title Registration (Registro de Qualificação de Especialista)

Conselho Federal de Medicina

Free English-language MCQ study adaptation for Brazil's Portuguese-language Título de Especialista em Clínica Médica (TECM — SBCM / AMB, Edital nº 2473/2026). Covers all core internal medicine domains: Cardiology, Pulmonology, Gastroenterology/Hepatology, Nephrology/Electrolytes, Endocrinology/Metabolism, Hematology/Transfusion, Infectious Diseases/Tropical Medicine, Rheumatology, Neurology, and Emergency Medicine/ICU.

Sample TECM Clínica Médica Practice Questions

Try these sample questions to test your TECM Clínica Médica exam readiness. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.

1A 62-year-old male with ischemic cardiomyopathy and NYHA Class III heart failure has a left ventricular ejection fraction (LVEF) of 28% despite optimized treatment with enalapril 20 mg BID, carvedilol 25 mg BID, and spironolactone 25 mg daily. His blood pressure is 118/74 mmHg, heart rate is 68 bpm (sinus rhythm), serum potassium is 4.4 mEq/L, and eGFR is 58 mL/min/1.73 m². According to the Diretriz Brasileira de Insuficiência Cardíaca (SBC), what is the most appropriate next step in disease-modifying therapy?
A.Switch enalapril to sacubitril/valsartan (with a 36-hour washout period) and add an SGLT2 inhibitor (dapagliflozin or empagliflozin).
B.Discontinue carvedilol and initiate ivabradine, while maintaining enalapril and spironolactone.
C.Add digoxin 0.25 mg daily and increase spironolactone to 50 mg daily without changing enalapril.
D.Add amlodipine 10 mg daily to achieve afterload reduction and lower neurohormonal activation.
Explanation: According to the Sociedade Brasileira de Cardiologia (SBC) guidelines for heart failure with reduced ejection fraction (HFrEF), guideline-directed medical therapy (GDMT) includes quadruple neurohormonal blockade: an ARNI (sacubitril/valsartan) replacing an ACEi (after a mandatory 36-hour washout to avoid angioedema), an evidence-based beta-blocker, a mineralocorticoid receptor antagonist (spironolactone), and an SGLT2 inhibitor (dapagliflozin or empagliflozin). Quadruple therapy significantly reduces all-cause mortality and heart failure hospitalizations in symptomatic HFrEF patients.
2A 58-year-old male presents to the emergency department (Unidade de Pronto Atendimento - UPA) with crushing substernal chest pain of 90 minutes' duration radiating to the left arm. Electrocardiogram reveals 3 mm ST-segment elevation in leads V1–V4 with reciprocal ST depression in II, III, and aVF. The nearest PCI-capable hospital is 3 hours away by ground ambulance. According to Brazilian acute coronary syndrome guidelines, what is the best immediate reperfusion strategy?
A.Administer intravenous fibrinolytic therapy (e.g., tenecteplase or alteplase) immediately within 10 minutes (door-to-needle), followed by transfer for pharmaco-invasive coronary angiography within 2 to 24 hours.
B.Transfer the patient immediately for primary percutaneous coronary intervention (PCI) without administering fibrinolytics, regardless of transport delay.
C.Administer unfractionated heparin and double-dose statin, observe clinical response for 6 hours, and perform elective angiography if pain persists.
D.Perform emergency bedside pericardiocentesis and start therapeutic anticoagulation with enoxaparin.
Explanation: According to SBC guidelines on STEMI (Infarto Agudo do Miocárdio com Supradesnivelamento do Segmento ST), when expected door-to-balloon time exceeds 120 minutes, immediate intravenous fibrinolytic therapy should be administered within 10 minutes of diagnosis if there are no contraindications. This should be followed by urgent transfer to a PCI center for routine coronary angiography between 2 and 24 hours (pharmaco-invasive strategy), or immediately if reperfusion fails.
3A 71-year-old female with a history of hypertension, type 2 diabetes, and permanent non-valvular atrial fibrillation has normal renal function. She has no history of stroke, TIA, or vascular disease. According to the CHA2DS2-VASc score and Brazilian cardiology consensus, what is her score and recommended stroke prevention strategy?
A.Score = 4; oral anticoagulation with a Direct Oral Anticoagulant (DOAC, e.g., apixaban, rivaroxaban, dabigatran, or edoxaban) is strongly recommended.
B.Score = 2; antiplatelet monotherapy with acetylsalicylic acid (aspirin) 100 mg daily is the preferred first-line therapy.
C.Score = 1; no antithrombotic or anticoagulant therapy is indicated given preserved left ventricular function.
D.Score = 5; combination therapy of warfarin plus clopidogrel and aspirin (triple therapy) is mandatory indefinitely.
Explanation: Her CHA2DS2-VASc score is 4: Age 65–74 (+1), Female (+1), Hypertension (+1), and Diabetes (+1). In non-valvular atrial fibrillation, a CHA2DS2-VASc score >= 2 in men or >= 3 in women carries a Class I recommendation for oral anticoagulation, with DOACs preferred over vitamin K antagonists (warfarin) due to lower intracranial bleeding risk and non-inferior efficacy.
4A 48-year-old male with untreated hypertension presents to the emergency department with severe throbbing headache, blurred vision, and dyspnea. Vital signs show BP 224/132 mmHg, HR 96 bpm, RR 26 bpm, and SpO2 90% on room air. Fundoscopy reveals bilateral flame-shaped hemorrhages, cotton-wool spots, and bilateral optic disc swelling (papilledema). Chest radiograph demonstrates diffuse pulmonary edema. What is the diagnosis and the most appropriate immediate pharmacological management?
A.Hypertensive emergency with acute pulmonary edema and malignant nephrosclerosis/retinopathy; initiate continuous intravenous sodium nitroprusside or nitroglycerin with intravenous furosemide, targeting a 20% to 25% reduction in mean arterial pressure within the first hour.
B.Hypertensive urgency; administer oral clonidine 0.2 mg or sublingual captopril 25 mg and discharge with outpatient follow-up in 48 hours.
C.Pseudohypertension; administer oral lorazepam and repeat blood pressure measurement in 3 hours.
D.Hypertensive emergency; rapidly decrease systolic blood pressure to below 100 mmHg within 15 minutes using boluses of hydralazine.
Explanation: This patient presents with a Hypertensive Emergency (Emergência Hipertensiva), defined as severe blood pressure elevation accompanied by acute, life-threatening target-organ damage (acute pulmonary edema and grade IV hypertensive retinopathy with papilledema). Immediate management requires ICU admission and parenteral vasodilators (IV nitroprusside or nitroglycerin) combined with IV loop diuretics, aiming to reduce mean arterial pressure by no more than 20–25% in the first hour to prevent ischemic cerebral, myocardial, or renal hypoperfusion.
5A 54-year-old male with a history of bicuspid aortic valve presents with 3 weeks of low-grade fever, malaise, night sweats, and a new holosystolic regurgitant murmur at the apex. Physical exam reveals non-tender erythematous macules on the palms (Janeway lesions) and subungual splinter hemorrhages. Blood cultures (3 sets drawn over 2 hours) grow Streptococcus gallolyticus (formerly S. bovis). In addition to targeted antibiotic therapy and echocardiography, what essential diagnostic investigation must be scheduled?
A.Total colonoscopy to screen for occult colorectal neoplasia or adenomatous polyps.
B.Gastroduodenoscopy to identify occult Helicobacter pylori gastric ulceration.
C.Bone marrow aspirate and biopsy to rule out acute myelogenous leukemia.
D.24-hour urine copper and ceruloplasmin testing to evaluate Wilson's disease.
Explanation: Streptococcus gallolyticus (Streptococcus bovis biotype I) bacteremia and infective endocarditis have a strong, proven association with occult colorectal malignancies, adenomas, and inflammatory bowel disease. Brazilian and international infectious disease guidelines mandate a complete colonoscopy during or immediately after treatment of S. gallolyticus endocarditis to detect and resect premalignant or malignant colonic lesions.
6A 78-year-old female presents with recurrent exertional presyncope, angina on climbing stairs, and progressive dyspnea. On physical exam, carotid pulses are diminished and delayed (pulsus parvus et tardus), and auscultation reveals a harsh, late-peaking systolic ejection murmur radiating to the carotids, with a soft, single second heart sound (S2). Transthoracic echocardiogram demonstrates an aortic valve area of 0.7 cm², mean transvalvular gradient of 48 mmHg, and peak velocity of 4.3 m/s with an LVEF of 52%. What is the diagnosis and definitive guideline-directed management?
A.Severe symptomatic aortic stenosis; aortic valve replacement (surgical AVR or transcatheter aortic valve implantation - TAVI) is indicated.
B.Moderate aortic regurgitation; conservative medical management with high-dose vasodilators (nitroprusside and hydralazine) without intervention.
C.Hypertrophic obstructive cardiomyopathy; initiate high-dose digoxin and perform dynamic stress testing.
D.Mitral valve prolapse; reassurance and prescription of beta-blocker PRN for palpitations.
Explanation: Severe aortic stenosis is defined by an aortic valve area < 1.0 cm² (or < 0.6 cm²/m²), mean gradient >= 40 mmHg, or peak velocity >= 4.0 m/s. Once cardinal symptoms (angina, syncope, or heart failure dyspnea) develop, average survival without valve replacement drops dramatically. According to SBC guidelines, aortic valve intervention (SAVR or TAVI based on heart team age/risk assessment) is a Class I indication and is the only definitive treatment to improve survival.
7A 28-year-old previously healthy woman presents with sharp, retrosternal chest pain that began 24 hours ago. The pain worsens with deep inspiration and when lying flat on her back, but is markedly relieved by sitting upright and leaning forward. On auscultation, a scratchy, high-pitched friction rub is heard at the left lower sternal border. ECG reveals diffuse, concave-upward ST-segment elevation across leads I, II, aVF, and V2–V6, accompanied by PR-segment depression in lead II and reciprocal PR-segment elevation in aVR. What is the first-line pharmacotherapy according to Brazilian cardiology guidelines?
A.High-dose Nonsteroidal Anti-inflammatory Drug (e.g., ibuprofen 600–800 mg TID or aspirin 750–1000 mg TID) combined with colchicine 0.5 mg daily (or BID if >70 kg) for 3 months.
B.High-dose oral prednisone (1 mg/kg/day) as initial monotherapy for 6 weeks.
C.Intravenous unfractionated heparin bolus followed by dual antiplatelet therapy with aspirin and ticagrelor.
D.Immediate pericardiocentesis and therapeutic drainage under fluoroscopic guidance.
Explanation: The clinical presentation and ECG findings (diffuse concave ST elevation and PR depression with aVR PR elevation) are diagnostic of acute idiopathic/viral pericarditis. First-line therapy consists of high-dose NSAIDs (ibuprofen or aspirin) combined with colchicine for 3 months. Colchicine significantly accelerates symptom resolution and reduces the recurrence rate from ~30% to under 10%. Systemic corticosteroids are reserved only for refractory cases, specific autoimmune etiologies, or NSAID contraindications, as early steroid use increases recurrence risk.
8A 32-year-old woman with no known medical history presents with sudden-onset palpitations and lightheadedness. Vital signs show BP 115/75 mmHg, HR 185 bpm, RR 18 bpm, and SpO2 98%. The 12-lead ECG demonstrates a regular, narrow-complex tachycardia (QRS duration 82 ms) with no visible P waves. Vagal maneuvers (modified Valsalva technique) fail to terminate the rhythm. What is the most appropriate next pharmacological intervention?
A.Adenosine 6 mg rapid intravenous push via a large peripheral vein followed immediately by a 20 mL saline flush.
B.Amiodarone 300 mg IV infusion over 30 minutes.
C.Immediate synchronized direct-current (DC) cardioversion at 200 Joules.
D.Digoxin 0.5 mg IV push repeated every 2 hours until heart rate drops below 100 bpm.
Explanation: This patient has hemodynamically stable Paroxysmal Supraventricular Tachycardia (AVNRT or AVRT). When vagal maneuvers fail, intravenous adenosine (initial dose 6 mg rapid push with a saline flush; if unsuccessful, 12 mg) is the first-line drug of choice. Adenosine transiently blocks conduction through the AV node, terminating AV node-dependent reentrant circuits in >90% of cases.
9A 68-year-old male with a history of anterior STEMI treated with primary PCI 4 months ago presents to the clinic. He is asymptomatic on optimal quadruple medical therapy. Echocardiogram reveals an LVEF of 31% with apical akinesis and a QRS duration of 105 ms in sinus rhythm on ECG. According to SBC guidelines, what device therapy should be evaluated to reduce the risk of sudden cardiac death?
A.Implantable Cardioverter-Defibrillator (ICD) for primary prevention of sudden cardiac death.
B.Cardiac Resynchronization Therapy Defibrillator (CRT-D) due to ischemic etiology.
C.Permanent dual-chamber pacemaker (DDD) for atrioventricular optimization.
D.External wearable defibrillator vest permanently without consideration of invasive devices.
Explanation: According to SBC and international guidelines, an Implantable Cardioverter-Defibrillator (ICD) is indicated for primary prevention of sudden cardiac death in patients with ischemic cardiomyopathy, NYHA Class II–III, and LVEF <= 35% despite >= 3 months of optimal guideline-directed medical therapy (and >= 40 days post-myocardial infarction).
10A 74-year-old male with a history of hypertension, stage 3 CKD, and paroxysmal atrial fibrillation is admitted with sudden onset of complete heart block (third-degree AV block) with a ventricular escape rate of 34 bpm. On exam, he is pale, diaphoretic, with BP 78/48 mmHg and cool extremities. Atropine 1 mg IV produces no change in heart rate or blood pressure. What is the immediate life-saving intervention while preparing for transvenous temporary pacing?
A.Initiate transcutaneous cardiac pacing immediately with adequate electrical and mechanical capture, along with intravenous chronotropic infusion (e.g., dopamine, epinephrine, or isoproterenol).
B.Administer IV amiodarone 150 mg bolus followed by continuous infusion.
C.Administer IV metoprolol 5 mg to reduce myocardial oxygen demand.
D.Perform immediate synchronized DC cardioversion at 100 Joules.
Explanation: In hemodynamically unstable bradycardia refractory to atropine (such as complete AV block with poor ventricular escape and shock), the ACLS protocol mandates immediate transcutaneous pacing while preparing for transvenous pacemaker insertion. Concurrently, an intravenous chronotropic agent (dopamine 5–20 mcg/kg/min or epinephrine 2–10 mcg/min) should be infused to maintain perfusion pressure.

About the TECM Clínica Médica Exam

The Título de Especialista em Clínica Médica (TECM) is the premier sufficiency examination qualifying Brazilian physicians as board-certified specialists in Internal Medicine (Clínica Médica). Jointly administered by the Sociedade Brasileira de Clínica Médica (SBCM) and the Associação Médica Brasileira (AMB), and recognized by the Conselho Federal de Medicina (CFM), the examination serves as the national standard of clinical excellence for adult inpatient and outpatient medical practice. Governed by Edital nº 2473/2026, the examination assesses comprehensive diagnostic reasoning, therapeutic management, preventive medicine, and acute care across all subspecialties of adult internal medicine. Candidates undergo a rigorous three-stage evaluation comprising the 1ª Etapa Prova Teórica (eliminatory online multiple-choice exam), 2ª Etapa Análise Curricular (classificatory evaluation of academic background, residency training, published research, and clinical practice), and 3ª Etapa Prova Prática / Teórico-Prática (eliminatory practical evaluation of clinical decision-making, emergency management, ECG interpretation, imaging review, and doctor-patient communication scenarios).

Assessment

Assessment under Edital nº 2473/2026 in two eliminatory phases, both presencial. 1ª Fase: Prova Teórica of 120 five-option objective questions (100 points maximum) combined with an Análise Curricular worth up to 10 further points — the curricular score is not eliminatory on its own and only serves to complete the theoretical mark. The specialty matrix covers Cardiologia, Infectologia, Pneumologia, Gastroenterologia, Endocrinologia, Nefrologia, Hematologia/Oncologia, Reumatologia, Neurologia and Clínica Geral/Geriatria, crossed with setting (ambulatório, enfermaria, emergência, UTI) and competency (tratamento, diagnóstico, urgência, prevenção). 2ª Fase: Prova Prática de Proficiência Clínica with two 10-minute stations assessing Conhecimento, Habilidade e Atitude (CHA).

Time Limit

Prova Teórica 5 hours (13h00–18h00); Prova Prática two stations of 10 minutes each

Passing Score

1ª Fase: at least 70% of the combined Prova Teórica + Análise Curricular score. 2ª Fase: minimum 7 of 10 points on the Prova Prática. The two phases are assessed independently and marks are not compensated between them.

Exam Fee

R$ 1.500,00 (sócios adimplentes da SBCM e da AMB) / R$ 2.250,00 (sócios adimplentes da SBCM ou da AMB) / R$ 750,00 (residentes ou estagiários com conclusão a partir de 2024) / R$ 4.500,00 (não sócios) (Sociedade Brasileira de Clínica Médica (SBCM) — Associação Médica Brasileira (AMB))

TECM Clínica Médica Exam Content Outline

10%

Cardiologia

Heart failure (HFrEF/HFpEF guideline therapy), systemic hypertension (SBC/DHA), acute coronary syndromes (STEMI/NSTEMI), cardiac arrhythmias (atrial fibrillation/flutter, ventricular tachycardia), infective endocarditis, valvular heart disease, pericardial diseases, and cardiogenic shock.

10%

Pneumologia

Community-acquired and hospital-acquired pneumonia, asthma (GINA), chronic obstructive pulmonary disease (COPD/GOLD), pulmonary thromboembolism, pleural effusions (Light's criteria), interstitial lung diseases, solitary pulmonary nodule, and ARDS/mechanical ventilation.

10%

Gastroenterologia e Hepatologia

Upper and lower GI bleeding, GERD and peptic ulcer disease, acute and chronic pancreatitis, cirrhosis and portal hypertension (varices, ascites, SBP, hepatic encephalopathy, HRS), inflammatory bowel disease (Crohn's, Ulcerative Colitis), autoimmune and viral hepatitides, and acute liver failure.

10%

Nefrologia e Distúrbios Hidroeletrolíticos

Acute kidney injury (KDIGO), chronic kidney disease and cardiorenal syndromes, water and sodium disorders (hyponatremia/hypernatremia), potassium and calcium disorders, acid-base disturbances (anion gap metabolic acidosis), glomerulonephritis (nephritic/nephrotic), lupus nephritis, and thrombotic microangiopathies.

10%

Endocrinologia e Metabologia

Type 1 and Type 2 diabetes mellitus (SBD guidelines, cardiorenal protection, acute decompensations DKA/HHS), thyroid disorders (hypo/hyperthyroidism, thyroid nodules), adrenal disorders (insufficiency, Cushing's, hyperaldosteronism), calcium and bone metabolism (hyperparathyroidism, osteoporosis), and pituitary diseases.

10%

Hematologia e Hemoterapia

Differential diagnosis of anemias (microcytic, macrocytic, hemolytic), thrombocytopenias (ITP, TTP, HIT), coagulation disorders, monoclonal gammopathies (multiple myeloma, MGUS), acute and chronic leukemias, lymphomas, rational blood component therapy (Ministry of Health guidelines), and febrile neutropenia.

10%

Infectologia e Arboviroses

Arboviruses in Brazil (Dengue, Chikungunya, Zika, Yellow Fever), Tuberculosis (SUS RIPE protocol), HIV/AIDS and opportunistic infections, tropical diseases (Leptospirosis, Chagas disease, Leishmaniasis, Paracoccidioidomycosis, Schistosomiasis), Sepsis-3 guidelines, CNS infections (bacterial/viral meningitis), and antimicrobial stewardship.

10%

Reumatologia

Rheumatoid arthritis, Systemic Lupus Erythematosus, Systemic Sclerosis (Scleroderma), Spondiloarthritides (Ankylosing Spondylitis, Psoriatic Arthritis), Sjogren's syndrome, Antiphospholipid syndrome (APS), systemic vasculitides (Giant Cell Arteritis, Takayasu, Polyarteritis Nodosa, ANCA-associated vasculitis), and crystal arthropathies (gout, CPPD).

10%

Neurologia Clínica

Cerebrovascular diseases (ischemic stroke, intracranial hemorrhage, SAH), epilepsy and status epilepticus, movement disorders (Parkinson's disease, tremor), neuroimmunological diseases (Multiple Sclerosis, Guillain-Barré, Myasthenia Gravis), dementias (Alzheimer's, Lewy body, FTD), acute headache syndromes, and central nervous system infections/abscesses.

10%

Medicina de Emergência e Terapia Intensiva

Cardiopulmonary resuscitation (ACLS 2020/2025), undifferentiated shock management, hypertensive emergencies, acute respiratory failure and rapid sequence intubation, acute poisonings and toxidromes (cholinergic, anticholinergic, opioid, sedative), severe trauma/TBI intracranial pressure management, and anaphylaxis.

How to Pass the TECM Clínica Médica Exam

What You Need to Know

  • Passing score: 1ª Fase: at least 70% of the combined Prova Teórica + Análise Curricular score. 2ª Fase: minimum 7 of 10 points on the Prova Prática. The two phases are assessed independently and marks are not compensated between them.
  • Assessment: Assessment under Edital nº 2473/2026 in two eliminatory phases, both presencial. 1ª Fase: Prova Teórica of 120 five-option objective questions (100 points maximum) combined with an Análise Curricular worth up to 10 further points — the curricular score is not eliminatory on its own and only serves to complete the theoretical mark. The specialty matrix covers Cardiologia, Infectologia, Pneumologia, Gastroenterologia, Endocrinologia, Nefrologia, Hematologia/Oncologia, Reumatologia, Neurologia and Clínica Geral/Geriatria, crossed with setting (ambulatório, enfermaria, emergência, UTI) and competency (tratamento, diagnóstico, urgência, prevenção). 2ª Fase: Prova Prática de Proficiência Clínica with two 10-minute stations assessing Conhecimento, Habilidade e Atitude (CHA).
  • Time limit: Prova Teórica 5 hours (13h00–18h00); Prova Prática two stations of 10 minutes each
  • Exam fee: R$ 1.500,00 (sócios adimplentes da SBCM e da AMB) / R$ 2.250,00 (sócios adimplentes da SBCM ou da AMB) / R$ 750,00 (residentes ou estagiários com conclusão a partir de 2024) / R$ 4.500,00 (não sócios)

Keys to Passing

  • Work through all 100 available questions
  • Review every answer and explanation
  • Track weak areas and revisit them
  • Use our AI tutor for tough concepts

TECM Clínica Médica Study Tips from Top Performers

1Master the latest Brazilian Society of Cardiology (SBC) guidelines on Heart Failure (quadruple therapy with ARNI/ACEi, beta-blocker, MRA, and SGLT2i) and Arterial Hypertension (combination therapy thresholds and target blood pressures).
2Focus heavily on Brazilian epidemiology in infectious diseases, including Dengue warning signs and SUS hydration protocols, the national RIPE regimen for Tuberculosis, Chagas disease manifestations, Visceral Leishmaniasis, and Leptospirosis.
3Review KDIGO criteria for Acute Kidney Injury staging, workup of hyponatremia and safe sodium correction limits, High Anion Gap Metabolic Acidosis etiologies, and lupus nephritis immunosuppressive regimens.
4Consolidate emergency medicine algorithms: ACLS cardiac arrest pathways, anaphylaxis intramuscular epinephrine dosing, Stevenson hemodynamic profiles in decompensated heart failure, and acute ischemic stroke thrombolytic eligibility.
5Familiarize yourself with Brazilian consensus on diabetes (SBD) emphasizing cardiorenal-protective agents (SGLT2 inhibitors and GLP-1 receptor agonists) in high-risk patients.
6Practice interpreting laboratory data, arterial blood gas analyses, electrocardiograms, and clinical vignettes with timed multiple-choice practice questions.

Frequently Asked Questions

What is the TECM (Título de Especialista em Clínica Médica)?

The TECM is the official specialist title in Internal Medicine (Clínica Médica) granted in Brazil by the Sociedade Brasileira de Clínica Médica (SBCM) and the Associação Médica Brasileira (AMB). Earning the title allows a physician to officially register as a Specialist in Internal Medicine with the Regional Medical Council (CRM) and obtain a Registro de Qualificação de Especialista (RQE).

What are the three stages of the TECM examination under Edital nº 2473/2026?

Under Edital nº 2473/2026 the examination has two eliminatory phases, both presencial. The 1ª Fase is a Prova Teórica of 120 objective questions with five alternatives each — the first 100 worth 0.8 point and the last 20 worth 1.0 point, up to 100 points — combined with an Análise Curricular worth up to 10 further points, which is not eliminatory in itself and only completes the theoretical mark. Candidates need at least 70% of that combined score to advance. The 2ª Fase is a Prova Prática de Proficiência Clínica of two 10-minute stations assessing Conhecimento, Habilidade e Atitude, marked out of 10 with a minimum of 7. The two phases are assessed independently and marks are not compensated between them.

What are the eligibility requirements to sit for the TECM exam?

Candidates must hold an active, unencumbered CRM license and either: (a) have completed an accredited 2-year Medical Residency in Clínica Médica recognized by the CNRM/MEC, OR (b) have completed at least 4 years of proven clinical activity in adult internal medicine (twice the residency duration) in recognized Brazilian medical services, verified through institutional documentation and curriculum analysis.

What is the passing score for the TECM specialist examination?

Candidates must achieve at least 70% (grade 7.0 on a 0.0–10.0 scale) on the eliminatory 1ª Etapa (Prova Teórica) to proceed to the practical stage, and achieve a combined qualifying score of 70% across the eliminatory theoretical and practical components.

Which medical specialties and clinical areas are assessed in the examination?

The examination assesses 10 core clinical fields: Cardiology, Pulmonology, Gastroenterology & Hepatology, Nephrology & Fluid/Electrolyte Disorders, Endocrinology & Metabolism, Hematology & Transfusion Medicine, Infectious Diseases & Arboviruses, Rheumatology, Clinical Neurology, and Emergency Medicine & Intensive Care.

Is this practice question bank an official SBCM/AMB exam simulation?

No. The official SBCM/AMB examination is administered in Portuguese. This question bank is an independent English-language 4-option multiple-choice study adaptation designed to help physicians and residents master internal medicine guidelines, pathophysiology, differential diagnoses, and management algorithms. It is not affiliated with or endorsed by SBCM or AMB.