The Day Portugal's Junior Doctors Queued in Five Halls to Claim a Specialty Is Over, and a Ranked List Decides October's Places Instead

Every autumn for years, the doctors who had just finished the general year of Portugal's Internato Médico (medical residency) travelled to one of five halls, in Lisbon, Porto, Coimbra, Funchal or Ponta Delgada, sat for hours, and when their name was called had to name a specialty and a hospital on the spot, choosing from whatever was still unclaimed at that exact moment. The whole country waited while each one decided. That is over.

The Administração Central do Sistema de Saúde (ACSS, the Central Administration of the Health System) published Comunicado n.º 11 on Friday 18 September, setting out how the 2026 choice of specialty training posts will work now that it has moved to what it calls an online asynchronous model. The vacancy map is expected in early October, and from the day it appears the process runs on a platform rather than in a room.

What actually changes

Candidates log in, read the vacancy map, pick the combinations of specialty and training hospital they are willing to take, and put them in their own order of preference. They can rewrite that list as often as they like. Submission closes at 23:59 on the day before their lot is processed, and at 10:00 the next morning the system runs the placements for that lot. Results appear on the platform immediately afterwards; ACSS's own timeline diagram puts them at 10:03.

The allocation rule is the one the hall used. Candidates are processed in the order of the lista de ordenação final, the final ranking built from a weighted combination of the Prova Nacional de Acesso mark and the normalised final mark of the integrated medical degree. For each candidate the system walks down their submitted list and assigns the first option that still has a vacancy and for which they are eligible. Once something is assigned, the rest of that candidate's list is not examined, the vacancy count is decremented, and the system moves on.

ACSS is emphatic on the point candidates worry about most: speed of submission changes nothing. Priority comes from the ranking, not from the hour you clicked, the device you used or how fast your connection is. Nor does putting a heavily contested option first cost you anything. If it has gone by the time your position is reached, the system simply considers the next item on your list with the priority your ranking gives you.

Lots, and the information they hand the people behind you

Candidates are grouped into successive lots, each lot being a band of positions on the final ranking. Submission opens for everyone on the first working day after the vacancy map is published, but each lot has its own closing date, with at least ten working days between publication of the map and the first closure. Lots are processed one after another, and ACSS says it will organise as many as the calendar allows, with the size of each depending on when the map comes out.

This creates something the old system could not. Candidates in later lots can see which vacancies the earlier lots took, and adjust their own lists accordingly, right up to 23:59 on their own closing date. The agency is careful to say this does not alter anyone's priority, since the earlier lots were processed in ranking order in the first place. What it changes is how much a candidate at position 900 knows before committing.

Nobody is obliged to list everything. A candidate may submit only the options they would actually accept, and can cancel the submission altogether within the window if none of them appeal. The system can only assign a post that appears on the candidate's own list, which means a short list carries a real risk: if none of its entries survives to your position, you go unplaced.

Who built it, and under which rules

The platform was developed by the Serviços Partilhados do Ministério da Saúde (SPMS, the Health Ministry's shared services company) with ACSS, and ACSS says it went through technical and functional testing with doctors nominated by the Ordem dos Médicos (Medical Association) and the Conselho Nacional do Internato Médico (National Medical Residency Council). Responsibility for running the procedure stays with ACSS, with SPMS providing technical support.

The timetable still has to respect the periods and deadlines in the Regulamento do Internato Médico annexed to Portaria n.º 79/2018, de 16 de março, including the notice required before a choice calendar is published. Under the old model the lots were announced ten days before the vacancy map, which used to appear at the end of October. This year the map is due at the start of the month.

Why the choice mechanism matters more than it sounds

It matters because a large number of newly qualified doctors respond to a bad outcome by walking away for a year. ACSS published its own survey on that in March 2026. The questionnaire went to a universe of 507 doctors who had completed general training in 2025 and chosen not to enter specialty training; 254 answered, a response rate of about 50 percent.

Asked to rank the reasons, 63 percent put "not getting a place in the specialty I wanted" first. Not getting the hospital or health unit they wanted came second or third for most. Pay and the cost of moving away from home ranked in the middle. Bureaucracy and poor supervision barely registered. And 80.7 percent said they intended to sit the Prova Nacional de Acesso again to improve their mark.

ACSS's own reading is that this is strategic waiting rather than abandonment, and that it is a planning problem: every deferred cohort pushes back the replacement of retiring specialists. The specialties those doctors said they were holding out for were Paediatrics (10.6 percent) and Orthopaedics (10.2 percent), then General Surgery (7.6 percent), with Anaesthesiology and Obstetrics and Gynaecology on 6.8 percent each. Medicina Geral e Familiar (general practice) and public health, the two areas the health service has the most trouble staffing, drew very little interest.

What this means if you use or work in the Portuguese health service

For candidates. The single most important change is that you now rank a list rather than make one decision under pressure. Order the list by what you genuinely want, because the algorithm reads it in your order and stops at the first thing it can give you. Do not pad it with posts you would refuse, and do not truncate it so tightly that you risk going unplaced.

For foreign-trained doctors. Eligibility conditions are unchanged by this communiqué; it governs how choices are expressed and processed, not who may apply. The mechanics, though, remove a real obstacle, since the old model required physical presence on a single named day at one of five venues.

For patients. The distribution of trainee doctors across the country is decided in this process, and it is decided in a few October mornings. Hospitals outside the main academic centres depend on what is left when the earlier lots have finished choosing.

For the wider staffing picture. A smoother mechanism does not create posts. The pressure points of the past year, from anaesthetists leaving Lisbon's children's hospital to the successive rewrites of the médico tarefeiro outsourcing regime, are about how many specialists exist and where they are willing to work.

The number to watch in October is not the length of a queue, because there will not be one. It is how many candidates finish the last lot without a placement, and how many of the unfilled posts are in general practice.