In Q3 and the first nine months of 2025, Afya delivered broad-based growth, with nine-month revenue up 13% to BRL 2,784 million, adjusted EBITDA up 19% to BRL 1,292 million (46.4% margin, +200 bps), and net income up 20% to BRL 593 million, alongside record operating cash flow and 101.5% cash conversion. Growth was led by undergraduate medical education (revenue +14%, 25,000+ students, 100% program occupancy) with the FUNIC acquisition and a new 100-seat Bragança authorization lifting approved seats to 3,753, while Continuing Education revenue rose 11% on a 65% B2B surge and Medical Practice Solutions grew 9% on clinical-management payers. Headwinds included a 36% one-time drop in residency-journey students from product consolidation, a second consecutive quarter of Whitebook subscriber losses following a 2024 price increase, and a rise in the effective tax rate to 9.7% from Pillar Two provisioning. Management executed a major October liability-management exercise - new commercial notes funding debenture prepayment and the early repurchase of SoftBank preferred shares - keeping cash available for M&A, buybacks, or dividends. Guidance points to ~5%-5.2% tuition increases and ~200 new seats in 2026, with the effective tax rate expected to converge toward the 15% Pillar Two minimum.
Thank you for joining us for Afya's Conference Call. I'm here today with Afya CEO, Virgilio Gibbon, and our CFO, Luis Andre Blanco. During today's presentation, our executives will make forward-looking statements. Forward-looking statements can be related to future events, future financial or operating performance, known and unknown risks, uncertainties, and other factors that may cause actual results to differ materially from those contemplated by these forward-looking statements.
Forward-looking statements in this presentation include, but are not limited to, statements related to the business and financial performance, expectations and guidance for future periods, or expectations regarding the company's strategic product initiatives and its related benefits. These risks include those more fully described in our filings with the Securities and Exchange Commission. The forward-looking statements in this presentation are based on the information available to us as of the date hereof.
You should not rely on them as predictions of future events, and we disclaim any obligation to update any forward-looking statements except as required by law. In addition, management may reference non-IFRS financial measures on this call. These measures are not intended to be considered in isolation or as a substitute of the results prepared in accordance with IFRS. This presentation has reconciled these non-IFRS financial measures to the most directly comparable IFRS financial measures. Now, let me turn the call over to Virgilio Gibbon, Afya's CEO.
Thank you, Renata, and thanks, everyone, for joining us today for our third quarter and nine-month conference call. This quarter reflects more than financial performance. It demonstrates how our strategy continues to position Afya for sustainable growth, transforming medical education across Brazil. We concluded our 13th semester after the IPO, delivering strong growth, profitability, and cash generation, and keeping 100% of occupancy in all of our medical programs in Brazil.
Our results highlight the strength of our ecosystem while advancing initiatives that will shape the future of medical education and medical practice. Today, I will cover key strategic developments and operational highlights that drove these results. Then, Luis Blanco will provide a detailed review of our operational and financial performance. Starting with slide number three, let's begin with our main performance highlights and strategic priorities for the quarter.
Our revenue for the nine-month period grew over 13% year-over-year, reaching BRL 2,784 million, followed by an adjusted EBITDA growth of almost 19% year-over-year, reaching BRL 1,292 million. Adjusted EBITDA margin for the same period reached 46.4%, an increase of 200 basis points over last year.
We also reported a new record cash flow from operating activities, ended the nine-month period with BRL 1,292 million, 11% higher than last year, with a cash conversion of 101.5%. Net income followed the same positive trend as the last quarter and reached BRL 593 million, a growth of 20% year-over-year, with a basic EPS reaching BRL 6.40, 20% higher than last year, reflecting stronger operational performance.
Turning to our operational updates, in this quarter, we maintain our leadership position in the medical education, supported by 3,653 approved medical seats and 3,753 seats as of today after the approval of 100 medical seats in Afya Bragança. Our number of undergraduate medical students has reached more than 25,000 students, representing 6% growth compared to the same period last year.
Furthermore, our medical school's net average ticket, excluding acquisition, increased over 3% in the nine-month period. In the Continuing Education segment, we continue to see solid results, presenting a revenue growth of 11% year-over-year, reaching BRL 208 million. For Medical Practice Solutions, we ended the quarter with an increase in revenue of over 9% year-over-year, reaching BRL 128 million in the nine-month period. Finally, our ecosystem reached 304,000 active users, reflecting strong engagement and broad adoption among physicians and medical students across Brazil.
Moving on to slide number four, we'll talk about our solid business execution within our three business units. Starting with the undergrad segment, we saw important movements throughout the quarter, such as an impressive gross margin expansion and the successful beginning of FUNIC operation, acquired in May of 2025. In addition, we are pleased to share that we received the authorization of expansion of 100 medical seats in Afya Bragança, bringing our total approved seats to 3,753 seats.
The Continuing Education segment was marked by an increase in graduate journey students, sustained by another round of organic expansion in our medical graduate campuses, with five new operating units in 2025 and a strong gross margin expansion. In this nine-month period, we saw a significant increase in B2B revenues, with 65% over the last period.
Lastly, in our medical practice solution segment, once again, we ended the quarter with a growth in the clinical management payers. In addition, we also saw an increase in B2P business to physician revenues, led by an 11% growth compared to the same period of the prior year. These results reinforce the opportunity ahead in medical practice solution, which continues to deliver increasing solutions for medical practice. In the next slide, I want to share how our ESG initiatives continue to create long-term value and strengthen Afya's commitment to sustainable growth.
Over the nine-month period, we delivered 700,000 free healthcare consultations, including more than 500,000 of them medical consultations. These achievements exceeded the target set for 2025 and reflect our strong partnership with IFC through the sustainability-linked loan, as well as our public commitment to the United Nations Sustainable Development Goal number three.
I also want to reinforce the creation of Instituto Afya, which represents a new chapter in our journey. This initiative strengthens our focus on sustainability and social impact, with a clear commitment to advancing research, science, and technology for the benefit of society, playing a strategic role in addressing non-communicable chronic conditions. Finally, Afya's leadership in ESG was recognized by Valor Econômico through the Valor 1000 Award, which evaluates companies based on financial performance and ESG practices.
Afya was honored as the top-performing education sector in Brazil for the fourth time in a row. And now, I'll be turning the call over to Luis Blanco, Afya CFO, to provide more insight into the financial and operational metrics. Thank you.
Thank you, Virgilio, and good evening, everyone. Starting with slide number seven for discussions of key operational metrics by business unit, starting with the undergraduate programs. Our number of medical students grew 6% year-over-year, reaching more than 25,000 students, while approved medical seats increased by almost 2% in the third quarter of 2025.
Considering the expansions of 100 seats in Afya Bragança approved last week, the expansions in approved medical seats would be over 4% as of today. Our medical school net average tickets, excluding acquisitions, increased by 3.4% for the nine months, reaching BRL 9,141. We have also achieved BRL 2,459 million in revenue, up from BRL 2,156 million from the prior year, an increase of over 14% due to higher tickets in medicine courses, the maturations of medical school seats, and acquisitions of FUNIC.
Regarding the revenue mix, 86% was derived from medical school students and 94% from health-related courses. On the next page, I'll present our Continuing Education metrics. We approach Continuing Education through three main journeys. Starting with the residency journey, we saw a 36% decrease, reaching 9,969 students by the end of the period. In the graduate journey, student numbers grew by 26%, reaching 9,180 students. Lastly, our other course and B2B offerings increased by 5% over the same nine-month periods of the prior year.
Overall, due to an increase in the average tickets per students, the Continuing Education revenue reached BRL 208 million in the nine-month periods of 2025, up from BRL 188 million, reflecting a growth of almost 11% over the same period of the prior year. This includes a 7% increase in B2P revenue and a staggering 65% increase in B2B revenue.
Moving to slide number nine, I will discuss the Medical Practice Solutions' operational metrics. The first graph shows our total active payers, which are the ones that generate revenues in the business to physician. The number of paying users reached 195,000, a 2% decrease over the same period of last year. The second graph highlights our monthly active users, which accounts for 228,000, lower than the 249,000 records over the same period of the prior year.
Lastly, the third graph shows revenue from our medical practice solutions segments, which grew over 9% year-over-year, reaching BRL 128 million. This growth was primarily driven by expansions in active payers in clinical management and a more favorable product mix. Of this total, BRL 114 million was generated by B2P, representing an 11% increase, while B2B contributed BRL 14 million, a 2.5% decrease in the nine-month period.
On the next slide, we also present Afya Ecosystem. We are pleased to highlight that Afya's substantial contributions to the healthcare community in Brazil. By the end of the third quarter of 2025, our ecosystem encompasses 304,000 physicians and medical students using our service and products.
Moving forward to slide number 11, I want to discuss our financial overview for the third quarter of 2025, starting with the next slide. With great satisfaction, I'm pleased to present another strong quarterly performance for Afya. Revenue for the third quarter of 2025 reached BRL 929 million, representing a 10% increase compared to the same period of the last year. Revenue totaled BRL 2,784 million for the nine-month period, up 13% year-over-year.
For the third quarter of 2025, adjusted EBITDA rose by 15%, reaching BRL 399 million, with an adjusted EBITDA margin of 43% and expansions of 160 basis points compared to the third quarter of 2024. For the nine-month period, adjusted EBITDA amounted to BRL 1,292 million, an increase of 19% over the prior year, with an adjusted EBITDA margin of 46.4%, representing a 200 basis points increase over the same period.
The increase in adjusted EBITDA margin was mainly driven by higher gross margins in the undergraduate and Continuing Education segments, restricted initiatives within Continuing Education and medical practice solutions, and improved efficiency in selling general and administrative expenses. Moving to slide 13, the year's cash flow from operating activities rose by 11%, reaching BRL 1,292 million, reflecting a strong operational performance. The operational cash conversion ratio was 101.5% in the nine-month period of 2025.
Net income for the third quarter of 2025 came at BRL 159 million, marking an increase of 28% over the same period of 2024. For the nine-month period ending in September, net income totaled BRL 593 million, up 20% year-over-year. This growth reflects stronger operational performance, combined with the recognition of deferred tax assets, partially offset by the additional taxation provisions related to OECD Pillar Two Global Minimum Tax Effects.
AFYA-based EPS for this quarter reached BRL 1.71, a 29% increase compared to the same quarter of 2024, with BRL 6.40 per share for the nine-month period of 2025, representing a 20% growth. And now, moving to my last three slides, I will discuss our cash and net debt position. I'll also give you more color on our cost of debt. On the next slide, we will discuss our gross debt.