Introduction: The Rural and Urban Marginal Health Service (SERUMS) is a mandatory program at the end of the medical career in Peru. The promotional grade point average (PPP) and the national medical examination (ENAM) grades are used when awarding places. Materials and methods: An analytical, retrospective study was conducted using the registration of SERUMS in the processes between 2008 and 2015. The differential between the ENAM and PPP grades was evaluated, by an adjudication process and according to the origin of the university. Association statistics were obtained. Results: From the 21,296 evaluated, the range of grades of the final average in the Peruvian universities was 10.3-12.7 (PPP: 12.7-14.0 and ENAM: 9.3-12.3). In Cubans it was 5.5-12.9 (PPP: 16.9-18.3 and ENAM: 0.0-10.1), in Bolivians it was 3.6-11.2 (PPP: 12.0-13.2 and ENAM: 0.0-10.3), and in other foreign universities it was 4.2-11.7 (PPP: 13.6-17.1 and ENAM: 0.0-10, 6). When calculating the ENAM-PPP differential, a statistically significant discrepancy (P <.001) was found in all cases, and depending on the type of university. Conclusions: There are statistically significant differences between the final grades of the PPPs and the ENAM according to the origin of the university. This could create inequity in choosing a place in the SERUMS, and could suggest that the acquisition of knowledge models are different, which should be evaluated in order to study their impact during the SERUMS.