Afya opened 2026 with 8% revenue growth to BRL 1,013 million, 4% adjusted EBITDA growth to BRL 511 million (a 50.5% margin, down 200 bps), and net income up 2% to BRL 262 million (EPS BRL 2.88), with strong free cash flow of BRL 376 million and 92.5% cash conversion. Growth was led by higher medicine-course tickets (net average ticket up 5% to BRL 9,634), more non-medical health undergrad students, the FUNIC acquisition, and 11% Continuing Education revenue growth to BRL 79 million. Margin compressed on higher costs, payroll and sales/marketing tied to an investment cycle in Continuing Education and Medical Practice Solutions, and net income was partly offset by an OECD Pillar Two tax provision. Medical Practice Solutions remained a soft spot, with active payers down 1% to 201,000 and Whitebook still losing users, though management is investing in AI features and the integrated Afya One platform with payoff expected from 2027. The company reduced net debt by BRL 280 million to BRL 1,151 million, kept leverage at 0.7x, and had its Aaa rating reaffirmed by Moody's with a stable outlook.
Thank you, Ana. Welcome to our first conference call of 2026. It is with much satisfaction that Afya starts another year of great operational and financial performance. These quarterly results show the high predictability of our business and success execution of our strategy that once again combines growth with cash generation. Afya three pillars business model. In this presentation, I will cover key strategic topics, including our performance and highlights, successful business execution across our three segments. Finally, Luis Blanco will provide an in-depth look at our financial and operational performance. Now turning to page number three. Let's begin by highlighting our performance achievements. Initially, our revenues increased by 8%, reaching BRL 1.013 billion, accompanied by a growth in adjusted EBITDA of 4% year-over-year, reaching BRL 511 million with a margin of 50.5%.
We also reported a free cash flow of BRL 376 million, reflecting 3% increase compared to the previous year, boosted by the solid operational results of the company with a cash conversion of 92.5% and a solid cash position of BRL 1.3 billion at the end of the first quarter. With this consistent momentum, our net income reached BRL 262 million, marking a 2% growth year-over-year with an EPS of BRL 2.88, a 3% increase compared to the previous year. This growth reflects stronger operational performance, partially offset by an provision related to the OECD Pillar Two global minimum tax. Moving to our operational updates. We have now 3,768 operating medical school seats with an increase of over 6% year-over-year.
Our number of undergrad medical students has reached over 26,000 students, representing over 2% growth compared to the first quarter of 2025. We increased the net average ticket of medical school by almost 5% year-over-year, reaching BRL 9,634. We continue to observe improving performance in the Continuing Education and Medical Practice Solutions segments. In Continuing Education, revenue increased 11% year-over-year, purely organically, reaching BRL 79 million. In Medical Practice Solutions, we saw a 4% growth in revenue compared to the first quarter of 2025, reaching over BRL 43 million. Our ecosystem has 304,000 active users, exemplifies substantial penetration among physicians and medical students in the country. Moving to slide number four, we will discuss our performance across our three business segments.
Start with the undergrad segment. We observed important movements throughout the quarter, such as higher tickets in the medicine course with almost 5% increase year-over-year above 2025 inflation. This growth was accompanied by a stable gross margin across the segment of 69%. In addition, we expanded our health science student base by 5,000 students compared to the first quarter of 2025. The Continuing Education segment delivered record on B2B revenue of BRL 74 million in the first quarter of 2026, supported by a record student base of 57,000 students and reflecting the continued strength of our product offering and engagement across the segment.
The Medical Practice Solutions segment delivered solid performance in the first quarter of 2026, supported by an increase of 6,000 clinical management active payers compared with the first quarter of 2025. B2B revenue grew by 17%, reflecting the continued progress of our product offering and commercial initiatives across the segment. I will now turn the call over to Luis Blanco, Afya's CFO, to provide further insight into the financial operational metrics. Thank you.
Thank you, Virgilio, and good evening, everyone. Starting with slide number six for discussions of key operational metrics by business unit. Starting with the Undergraduate Programs.
Our medical student base grew by 2% compared with the first quarter of 2025, reaching 26,000 students. While operating medical school seats increased by over 6% year-over-year to 3,768. Our medical school net average ticket increased by 5%, reaching BRL 9,634 in the first quarter of 2026. Revenue for the Undergraduate segment saw an 8% increase, achieving BRL 892 million. 86% of which is related to medicine 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, which encompass products focused on the residency preparation.
We saw a 20% decrease, reaching 9,744 students by the end of the period. In the graduate journey, focused on specialization tests and preparations and graduate courses in medicine, the students grew by 15%, reaching 9,855 students. Lastly, our other course B2B offerings increased an impressive 41% over the same three-month period of the prior year. Continuing Education revenue grows to BRL 79 million in the three-month period of 2026, up from BRL 71 million in the three-month period of 2025, reflecting a growth of 11%. This includes a 13% increase in B2B revenue and 14% decline in B2B. Moving to slide number eight, I'll 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 division. The number of active payers declined to 201,000, a 1% decline over the same quarter last year. The second graph highlights our monthly active users, which account for 221,000, a reduction of 10% compared to the same period of the prior year. Lastly, in our final graph represents revenue of our Medical Practice Solutions segments, which has expanded by over 4% compared to the same quarter of the last year, reaching BRL 43 million. Of this total, BRL 38 million was generated by B2B, showing an increase of 3%. While B2B contributed to BRL 5 million, 17% increase over the same quarter last year. In the next slide, we presented our Afya ecosystem.
We're pleased to highlight Afya's substantial contributions to the Brazilian healthcare community. By the end of the first quarter of 2026, our ecosystem encompassed 304,000 physicians and medical students using our service and products. Moving forward to page 10, I want to discuss our financial overview for the first quarter of 2026, starting with the next slide. With great satisfaction, I present another strong quarterly performance for Afya. Revenue for the first quarter of 2026 reached BRL 1,013 million, representing an 8% increase compared to the same quarter of last year. The quarter revenue increase has mainly due to higher tickets in med-medicine courses, the increase in non-medical undergraduate students, the acquisitions of FUNIC and advancements of the Continuing Education segment.
In the first quarter of 2026, adjusted EBITDA rose by 4%, reaching BRL 511 million with an adjusted EBITDA margin of 50.5%, a reduction of 200 basis points compared to the first quarter of 2025. The reduction in adjusted EBITDA margin was primarily driven by higher costs and expenses in Continuing Education and Medical Practice Solutions segments, mainly reflecting a lower gross margin compared with the first quarter of 2025 and higher payroll, sales, and marketing expenses associated with the ongoing investment cycle in both segments. Moving to the next slide. The first quarter cash flow from operating activities rose by 0.6%, reaching BRL 473 million. The operating cash flow conversion ratio was 92.5%.
Net income for the first quarter of 2026 totaled BRL 262 million, representing a 2% increase from the same period of 2025. This growth reflects a stronger operation performance, partially offset by an additional taxations provisions related to OECD Pillar Two global minimum taxation. Despite a lower adjusted EBITDA margin driven by higher expenses in Continuing Education and Medical Practice Solutions. Net income growth was sustained, supported by the disciplined execution and the consistency of our business model. Regarding EPS, we achieved BRL 2.88 per share in the three-month period, representing a 3% increase year-over-year. Now moving to my two last slides, I will discuss our cash and net debt position, also giving more color on our cost of debt.
This slide presents a table detailing our gross debt compositions at the end of the 1st quarter of 2026, and the total cost of debt covering our primary obligations. Afya capital structure remains solid, with a conservative leverage positions and the low cost of debt. Afya net debt, excluding IFRS 16 divided by the midpoint of the 2026 adjusted EBITDA guidance was 0.7x. Our financial discipline was also independently recognized. On May 6, Moody's reaffirmed Afya credit rating at Aaa with a stable outlook, reflecting our consistent revenue growth, above industry average margins, solid cash generation and robust liquidity. While also recognizing our strong competitive position and disciplined approach to liability management and capital allocation. On the next page, we can look closely at the net debt variation.
As of the end of the first quarter of 2026, our net debt has reduced to BRL 1,151 million when compared to the end of 2025. A reduction of BRL 280 million. Even considering the repurchase of BRL 70 million in treasury, in the first quarter, reflecting our strong operational performance and capital allocation discipline. This concludes our prepared remarks. We are pleased with the progress achieved during the quarter and with the consistency of our executions across the business segments. Our commitment to advancing student medical journey through an integrated ecosystem of educational and medical grade solutions remains unchanged. Supporting students through their path to became physicians, promoting continual medical learning and enhancing physician decision-making and productivity. Looking ahead, we remain focused on executing our strategy with discipline and capturing the opportunities ahead.
I will now open the conference for the Q&A session. Thank you.