Secretive Training Rules Spark Mass Dropouts from Portugal’s Emergency Academy

Anyone who has tried to dial 112 in Portugal knows how reassuring it is to hear the siren within minutes. That confidence, however, is wobbling after a bruising start to the year inside the training academy of the Instituto Nacional de Emergência Médica (INEM). A quarter of the 200 recruits signed up in January for the prized Técnico de Emergência Pré-Hospitalar certificate walked away or were expelled, claiming they only learned the make-or-break rules once their ink had dried on the contract. The row has erupted just as the Government is scrambling to double intake, raising uneasy questions about service quality for everyone who relies on an ambulance in Portugal—locals, tourists and the country’s growing expat community alike.

Why the training upheaval matters for newcomers in Portugal

Reliable emergency response is a non-negotiable expectation for foreign residents weighing a move to Lisbon, Porto or the Algarve. INEM dispatches the yellow ambulances that handle every life-threatening call nationwide, and its roster already runs thousands short of what unions say is safe. If trainee attrition spikes, the impact is likely to be felt first in the less populated interior where backup is thin and response times are longer. Even urban expats with private insurance ultimately depend on the same pool of paramedics whenever a 112 call is routed through INEM’s command centre.

Inside the January cohort: contracts first, rules later

Recruits report that they signed contracts on 20 January only to receive, three days later, a jury memo declaring certain course modules “eliminatory.” Dozens were later cut for failing a single practical drill—something they insist was never spelled out during the hiring roadshows. Other grievances include mould-stained mattresses, erratic grading between regional campuses and cafeteria food unfit for long night shifts. INEM counters that it registered just two official complaints, plus 18 informal objections delivered during the usual “right to be heard” window, and stresses that all procedures were published online. Nevertheless, its own figures confirm roughly 25% attrition—high in a context where every technician counts.

Official responses: tweaks, audits and tight lips

Stung by a Lusa newswire leak that exam answers were being circulated on WhatsApp, INEM president Sérgio Janeiro promised in April to vary the wording of theoretical tests from class to class. The Health Ministry later disclosed that the Inspeção-Geral das Atividades em Saúde completed an audit containing 44 recommendations on recruitment transparency, which the agency must now address. The union STEPH, meanwhile, has put its legal team on standby to contest expulsions and is pressuring parliament for an inquiry. For the moment, neither INEM nor the Ministry has hinted at reinstating any of the excluded trainees, leaving a cloud over upcoming intakes.

A staffing crunch years in the making

Portugal entered 2025 with what unions describe as a shortage of about 1 110 emergency technicians—nearly three times the number hired in a booming tourist season. In May the Government authorised another 200 hires, on top of the 200 already recruited, to calm fears of summer chaos. Yet even if every future course achieved a 100% pass rate—far from guaranteed—that would still leave INEM hundreds below the threshold that operators say is needed to keep all ambulances rolling without punishing overtime. The union blockade on extra hours, in force since 2024, has already grounded dozens of vehicles on peak weekends.

Thinking of joining INEM? What foreign paramedics should know

EU citizens with recognised qualifications can, in theory, apply for the next Concurso TEPH scheduled for mid-June. But the recent controversy underlines the importance of asking upfront for the full training handbook, evaluation criteria and accommodation details—in writing—before signing anything. The wage scale begins just under €1 100 net, rising with seniority and specialised skills such as motorcycle or helicopter deployment. Lisbon’s high rents, irregular shifts and a culture of heavy overtime can erode that figure quickly, so many expats patch income with private clinic work—something INEM allows only once probation is complete. Whether the agency’s promised overhaul of assessments and living conditions will be enough to persuade international talent to take the plunge remains an open question.

What this means for patients on the ground

For foreigners already settled in Portugal the immediate advice is simple: keep calling 112 without hesitation—response teams remain professional and well-trained. Yet the behind-the-scenes attrition illustrates how fragile the safety net can become when recruitment pipelines falter. As tourists return in record numbers and the population ages, sustaining a robust, transparent training program may prove just as critical to Portugal’s global image as its beaches or Michelin stars. The next few months, when fresh cohorts enter the academy under revised rules, will reveal whether INEM can restore confidence before the busy summer season peaks.