A complete breakdown of Italy's entrance exam for English-taught Medicine & Surgery.
Written by students currently in Italian medical schools. Facts verified against Decreto n. 599/2025. Last updated April 2026.
The IMAT is Italy's single entrance exam for English-taught Medicine, Dentistry, and Veterinary programmes at state (public) universities. One paper, one date, set nationally by the Ministry of Education (MUR) and delivered by CINECA.
Cambridge Assessment ran the test through 2022. From 2023 onwards CINECA administers it under MUR oversight. The 2025 syllabus and procedures are fixed by Decreto n. 599/2025.
One paper, five sections, five choices per question. 60 questions across 100 minutes means you average 1 minute 40 seconds per question — but the real distribution is uneven because Biology and Chemistry reward the extra time.
No calculator. No outside materials. The paper is in English; your answers are in English; there is no Italian language prerequisite to sit the exam.
Biology alone is 38% of the paper and the first tiebreaker. That is why a serious IMAT prep block almost always starts with Biology — it repays study time twice: once in raw marks, once in tie-break safety.
Correct pays +1.5. Wrong costs −0.4. Blank is 0. The third answer — blank — is a strategic choice, not a surrender. Which means half the exam is what you know, and half is knowing which ones to walk away from.
| Scenario | EV per question | Commentary |
|---|---|---|
| Blind guess | −0.02 | Net loss over the paper. Blank it. |
| Eliminate one | +0.075 | Small gain. Breaks even across the paper. |
| Eliminate two | +0.233 | Solid gain. Should guess. |
| Eliminate three | +0.55 | Big gain. Always commit. |
Run those numbers across 60 questions and a disciplined guesser picks up 4–6 marks over someone who either leaves everything blank or swings at everything. In a year where Bologna's non-EU cutoff sat around 61, that's the whole margin.
When two candidates score identically, the decree resolves ties section by section. Biology wins first. Chemistry second. Physics & Maths third. Logic fourth. Reading & GK fifth. Additional tiebreakers including age and language certification apply per the decree.
The IMAT runs one paper, but seats are allocated through two separate ranking systems — one for EU & EU-equivalent candidates, one for non-EU candidates. The difference is structural, and the non-EU side is much less forgiving.
Rank all universities in order of preference before the exam. National ranking. Multiple scorrimento (scrolling) rounds reassign seats as higher-ranked candidates decline. 5-working-day confirmation windows. 20-point minimum floor.
One university chosen before the exam — that choice is final. Local ranking per university. No scrolling rounds to speak of (1–2 seats per year, at most). Above-zero floor, but in practice the cutoff is the Nth score where N = non-EU seat count.
The 16 public universities offering English-taught Medicine in 2025. EU/non-EU counts per Decreto n. 599/2025. Cutoff column is each university's 2025 non-EU entry score on the /90 scale.
| University | EU | Non-EU | 2025 non-EU cutoff |
|---|---|---|---|
| Milan (Statale) | 55 | 15 | 72.9 |
| Bergamo (Bicocca) | 30 | 18 | 65.1 |
| Padua / Venice | 75 | 25 | 65.4 |
| Pavia | 103 | 40 | 71.9 |
| Turin | 70 | 30 | 67.1 |
| Parma | 75 | 45 | 67.6 |
| Bologna | 130 | 20 | 71.1 |
| Bari | 69 | 11 | 50.9 |
| Rome (Sapienza) | 45 | 13 | 65.8 |
| Rome (Tor Vergata) | 60 | 20 | 69.1 |
| Naples (Federico II) | 25 | 45 | 63.1 |
| Caserta (Vanvitelli) | 60 | 50 | 66.2 |
| Ancona (Marche) | 20 | 60 | 58.2 |
| Messina | 55 | 56 | 58.2 |
| Catania | 0 | 60 | 61.6 |
| Cagliari | 80 | 20 | 54.7 |
Source: MUR Decreto n. 599/2025. Cutoffs are 2025 non-EU entry scores on the /90 scale.
Six years in Italian. The €900–€4,000 tuition band. ISEE thresholds, DSU scholarships, how a non-EU permit actually gets stamped, what your Monday in Pavia looks like when November fog sits on the Ticino. We wrote that page separately — because the exam deserves a clean answer, and everything after the exam deserves more room than a sidebar.
CBSE, ISC, A-Levels, IB, or equivalent. Final-year students can register provisionally.
Same paper, same date. Only the admission process (EU vs non-EU) differs.
The IMAT itself is the entrance. Individual universities may ask for English proof at enrolment.
It's not IQ and it's not the textbook you bought. By the time students are within striking distance of a 60, they know the Biology. What separates the top quartile is three quiet habits: timed mocks done weekly (not stockpiled for the last month), Biology depth beyond the syllabus summaries, and the discipline to lock a blank instead of a swing when the math doesn't support a guess.
Those are trainable. They're not mysteries. But they don't happen on their own.
“In our student tracking, the 75+ scorers almost always share one habit — they can tell you their EV on every answer before they commit. That's trainable.”
Most IMAT pages end with a cheer. We'll end with a choice. If the exam is more than 20 weeks away, the leverage is structured prep — it compounds. If you need to know which university is actually realistic for your score range and passport, that's a different conversation and a shorter one.
Written by IMAT high scorers currently in Italian medical schools. Facts verified against Decreto n. 599. Last updated April 2026. Something off? hello@imatquest.com.
