The IMAT: how Italy's English-taught medicine test works

The IMAT is the national test for English-taught medicine, dentistry and veterinary degrees at Italy's state universities. It is one paper, sat once a year, and the rules around it change a little every cycle. This guide sets out how it worked for the 2026 sitting, taken directly from the ministerial decree, so you know what to expect when the 2027 decree is published. Private medical schools choose their students differently, with their own tests early in the year; see below. If you have a son or daughter applying, the sections on the two rankings and the non-EU steps are the ones to read together.

What the IMAT is, and who runs it

IMAT stands for International Medical Admissions Test. Each year the Ministry of University and Research (MUR) publishes a decree that fixes the date, the rules and the number of places. CINECA, the Italian university consortium, writes the questions, runs the test and calculates the scores. It has done so since 2023; until 2022 the test was set by Cambridge Assessment, which is why older preparation material still carries Cambridge's name.

One score gives access to three kinds of degree taught in English: Medicine and Surgery, Dentistry, and, since 2025, Veterinary Medicine. The decree's table of places also lists private universities, but that does not make the IMAT their entrance test: the private schools select through tests of their own.

You may have read about Italy's 2025 reform of medical admissions, the open first semester known as the semestre filtro. That reform applies to programs taught in Italian. English-taught programs are expressly left out of it and keep the IMAT.

The format

The IMAT is a paper test of 60 multiple-choice questions, each with five options, answered in 100 minutes. The questions are split like this:

Biology and chemistry together are 38 of the 60 questions. The official syllabus is published as an annex to the decree and is pitched at the level of the final years of Italian secondary school.

You do not have to fly to Italy to sit it. The test is also held at centres abroad; the 2026 list included Pakistan, India, the United Arab Emirates, Saudi Arabia, Turkey, the United Kingdom and the United States, among others.

How it is scored

• Correct answer: 1.5 points
• Wrong answer: minus 0.4 points
• Blank: 0 points

The maximum is 90. EU candidates, and non-EU candidates who live in Italy, need at least 20 points to be ranked at all. Non-EU candidates who live abroad only need a score above zero. A score counts only for the year you sit the test; it cannot be carried to a later year.

When two candidates have the same score, the tie is broken by the subject scores in this order: biology, chemistry, physics and mathematics, logical reasoning, reading. Next comes holding a recognised English certificate (or having studied for at least a year at an English-medium school), then a recognised disability, and finally age, in favour of the younger candidate.

Two different rankings

This is the part to read twice. Which ranking you are in decides where you can apply and how you should choose.

EU candidates and non-EU candidates living in Italy

They go into one national ranking. When you register you list your universities in order of preference, and the list is locked when registration closes. Places are then handed out in rounds, called scrolls. In each round you are either assigned (you have your best available preference and must enrol within four days or lose it), booked (you have a lower preference and can take it or wait for a better one) or waiting. Anyone not yet enrolled must confirm their interest on Universitaly after every scroll, by 12:00 Italian time on the fifth day, counting the day the scroll is published and leaving out Saturdays and public holidays. Miss it and you drop out of all later rounds, whatever the reason. Someone you trust can do it for you.

Non-EU candidates living abroad

They compete only for the places reserved at the one university where they pre-enrolled on Universitaly, in that university's own ranking. There is no national list of preferences for them. Choosing that one university, by looking at how many non-EU places it has and, where the university publishes them, last year's results, is the most important decision a non-EU applicant makes.

The 2026 calendar

Two lessons from this table. Registration is short and late in the summer, not in spring. And the test date moves every year: the 2023 test was held on 17 October, and even in 2026 the ministry first announced 30 September before moving the test to 29 September. Never plan around last year's date; plan around the decree for your year. The decree does not print the registration fee; it is published on Universitaly when registration opens.

Extra steps for non-EU applicants

If you need a visa, you also pre-enrol on Universitaly for the university you are applying to. The university checks and validates the application, and only then can you apply for a student visa at the Italian embassy or consulate in your country of residence. For 2026/27 the visa application must be lodged by 30 November 2026; for 2027/28 the ministry has set 31 October 2027. Universities can set earlier deadlines of their own. The ministry's circular on international students says the enrolment procedures for medicine, dentistry and veterinary medicine will be set out in a separate notice, so read that notice when it appears.

Each university also sets its own pre-enrolment window, and some close well before the test. In 2026 the University of Catania's pre-enrolment deadline on Universitaly was 31 July, while the University of Turin's window ran from 26 August to 11 September. From 2026/27 a university may validate pre-enrolments only up to its quota of places for foreign students plus 20%, so a popular university can fill early. Apply in spring, not in late summer.

Regional DSU grants run on their own calendar, with deadlines usually in July, August or September, before the test. A medicine applicant who wants to apply does so before sitting the IMAT; our DSU guide explains how the system works.

How many places there are

For 2026/27 the decree lists 2,430 Medicine and Surgery places for EU candidates (and non-EU candidates living in Italy) and 1,362 for non-EU candidates living abroad. Those totals include programs still waiting for accreditation and 320 non-EU places at Tor Vergata's campus in Tirana, Albania, so the number of places in Italy itself is lower. Dentistry has 49 and 11 places, at Sapienza and Siena; Veterinary Medicine has 63 and 7, at Bologna and Naples Federico II.

Non-EU places vary a lot between universities, from none at all to several hundred at one teaching site. The table of places for your intake is the starting point for choosing where to pre-enrol; ask us for it if you cannot find it in the decree.

Private medical schools: their own tests

The decree's table lists places at private universities such as Humanitas, San Raffaele, Cattolica, Campus Bio-Medico and UniCamillus. Their students are chosen by each school's own admission test, under its own call, months before the IMAT. For 2026/27 the first sessions ran in February and March 2026: San Raffaele's non-EU sessions on 11 February and 4 March, Campus Bio-Medico's test on 19 February, Humanitas's HUMAT in two rounds in March.

For 2027/28, Cattolica's call is already out: applications close on 17 February 2027 and the online exam is on 17 March 2027. The other schools' calls follow; their first 2026/27 sessions ran in February and March.

A family that waits for the September IMAT has already missed most of these. If a private school is on your list, its call is your first deadline. Our guide to the private schools' tests compares their formats, fees and dates.

If you are sitting it again

Your old score does not carry over: you register and sit the whole test again in the year you apply. What does carry over is what you learned. Look at your own paper and score from your last sitting, find the sections where wrong answers cost you most, and practise the guessing decision as hard as the content. Your university choice can change too, so check the places table again for your new intake.

How to prepare

• Study to the official syllabus. It is an annex to the decree. The old Cambridge specifications are out of date.
• Use every past paper. The ministry publishes every IMAT paper from 2011 onwards on its admissions site. In the published versions the correct answer is always option A, so shuffle the options when you practise.
• Give biology and chemistry the most time. They are almost two thirds of the paper.
• Practise against the clock. 100 minutes for 60 questions leaves under two minutes a question, with reading time included.
• Train the guessing decision. Know before test day when you will answer and when you will leave a question blank.

Questions students and parents ask

Rules change every year: always confirm dates in the official call for your year.