IMAT Exam: Complete Guide for Studying Medicine in Italy in English

If you want to study Medicine, Dentistry or Veterinary Medicine in Italy in English, you will almost certainly meet the IMAT exam.

The International Medical Admissions Test (IMAT) is a national, standardised exam in English used to select students for a limited number of public medical programmes taught in English in Italy. It is still required even after the reform of Italian-taught Medicine, which replaced the old TOLC-MED with the new “filter semester”. That reform does not apply to English-taught courses, so IMAT remains the selection method for these programmes.

This guide explains:

what the IMAT exam is and how it works today,
its structure, scoring and timing,
who needs to take it,
how IMAT fits into the new Italian Medicine system,
and how you can start preparing effectively.

1. What is the IMAT exam?

The IMAT (International Medical Admissions Test) is:

a pen-and-paper, multiple-choice exam,
written entirely in English,
used for admission to certain public Italian universities that offer Medicine and Surgery, Dentistry and, from 2025, some Veterinary Medicine places in English.

It is organised each year by the Italian Ministry of Universities and Research (MUR), currently without Cambridge Assessment, though the format is still based on the original joint specification.

Key facts in one glance

Format: 60 multiple-choice questions, 5 options each
Duration: 100 minutes
Language: English
Subjects: Reading & General Knowledge, Logic, Biology, Chemistry, Physics & Mathematics
Scoring: maximum 90 points, with +1.5 / –0.4 / 0 marking scheme
When: usually one test day in mid-September (e.g. 17 September 2024 and 17 September 2025)
Where: test centres in Italy and in certified locations worldwide
Registration: online via Universitaly within a short window announced in the official ministerial decree

2. IMAT exam structure: sections and question breakdown

For the current IMAT (2024–2025 decrees), the structure is:

Total: 60 questions, 100 minutes
Sections:

Reading Skills & General Knowledge – 4 questions
- short texts and cultural/ethical/political questions
- tests your ability to understand written English and connect information
Logical Reasoning & Problem Solving – 5 questions
- puzzles, patterns, arguments, data interpretation
- measures abstract reasoning and critical thinking
Biology – 23 questions
- cell biology, genetics, molecular biology, physiology, anatomy, ecology
Chemistry – 15 questions
- general and organic chemistry, stoichiometry, solutions, bonds, periodic table
Physics & Mathematics – 13 questions
- algebra, equations and inequalities, probability, geometry, kinematics, basic dynamics, thermodynamics

All questions are single-best-answer multiple choice; only one option is correct.

The test paper is not split by time blocks: you have 100 minutes total and can move freely between questions, answering in any order you like.

3. Scoring and minimum thresholds

IMAT uses a negative marking scheme:

Correct answer: +1.5 points
Wrong answer: –0.4 points
No answer: 0 points

The maximum score is therefore:

60 × 1.5 = 90 points

At the end you receive:

a total score out of 90,
and a section breakdown (Biology, Chemistry, Physics & Maths, Logic, Reading & General Knowledge).

Minimum scores

According to the recent decrees:

EU candidates and non-EU residents in Italy:
- must score at least 20 points to be considered.
Non-EU candidates resident abroad:
- must score above 0 to appear in their ranking (in practice, competitive scores are much higher).

Tie-breaking

In case of a tie in total score, candidates are ranked based on:

higher Biology score, then
Chemistry,
Physics & Mathematics,
Logic,
Reading & General Knowledge,
followed by language certifications and, if needed, the younger candidate by date of birth.

4. IMAT, the Medicine reform and who needs this exam

Italy recently introduced a major reform for Medicine taught in Italian:
traditional entrance tests (including TOLC-MED) were abolished, and replaced with an open “filter semester” where everyone can enrol, then selection happens after common exams in the first term.

Crucially:

This reform does not apply to Medicine programmes taught in English.

For public universities with English-taught Medicine, Dentistry and some Veterinary Medicine, IMAT remains the official selection test and is still run as a single national exam in English, with quotas for each university.

So you need the IMAT test if you are applying to:

Medicine and Surgery (English) at universities like Milan (IMS), Pavia, Rome “La Sapienza”, Bari, Messina, Turin, etc.
Dentistry programmes taught in English at certain public universities,
and, from 2025, some Veterinary Medicine places in English when listed in the decree.

Private universities (Humanitas, San Raffaele, Cattolica, UniCamillus, MEDTEC, etc.) continue to use their own admission tests, not IMAT.

Always check:

the annual ministerial decree for IMAT, and
the call for applications on each university’s website,

to see which programmes accept IMAT, how many places there are, and the exact calendar.

5. IMAT dates, registration and test centres

While exact dates change each year, the pattern is stable:

Test day: mid-September (for 2024 and 2025, it is on 17 September).
Duration: 100 minutes (usually starting at 11:00 in Italy, with times adjusted abroad).
Registration: about 1–2 weeks in late August / early September via the Universitaly portal, where you:
- create an account,
- select the universities in your preference order,
- choose your test centre,
- pay the IMAT fee.

Test locations

IMAT is offered:

at Italian universities hosting English-taught Medicine, and
at certified centres worldwide (e.g. London, Paris, Athens, São Paulo, Toronto, Tel Aviv, multiple Asian cities – exact list changes yearly).

You choose a centre when you register; each centre has limited places, so it’s wise to register early in the window.

6. IMAT rankings and quotas

IMAT has a national dimension: all candidates sit the same exam on the same day, and the Ministry produces central rankings.

Recent decrees use this logic:

Two national rankings for:
- EU citizens and equivalent candidates
- non-EU citizens resident in Italy
Separate rankings for non-EU citizens resident abroad (managed by each university, but still based on IMAT scores).

Each public university has:

a total number of places,
divided into EU/equivalent and non-EU abroad quotas.

When you register, you rank your preferred universities; the combination of your IMAT score + quota + preference order determines whether and where you get a place.

Because places for English-taught Medicine are limited and competition is strong, serious preparation is essential.

7. How hard is the IMAT exam really?

IMAT is designed to discriminate among very strong candidates – not just to check basic knowledge.

Common difficulties:

fast reading and logical reasoning under time pressure,
dense Biology and Chemistry questions that mix multiple topics,
Physics & Maths questions for students who haven’t done much science recently,
exam stress: 100 minutes for 60 questions with negative marking.

You don’t need to know all of first-year medicine, but you do need:

a solid high-school level in Biology, Chemistry, and at least basic Physics/Maths,
strong reasoning and problem-solving habits,
and familiarity with the IMAT question style.

8. How to start preparing for IMAT

Here’s a sensible roadmap for most international students.

Step 1 – Learn the format

Before anything else, you should be able to answer from memory:

How many questions and minutes?
How are questions divided by subject?
What is the +1.5 / –0.4 / 0 scoring rule?
What minimum score do you need for your category?

Read the latest ministerial decree and at least one university page (e.g. University of Milan IMS) carefully.

Step 2 – Do a diagnostic test

Use one recent past paper (2024 or 2023) and simulate the real conditions:

60 questions, 100 minutes,
black pen, answer sheet, no calculator,
apply the official scoring afterwards.

Then analyse:

Which section is lowest?
Are you running out of time, or losing marks through rushed guessing?
Are there big gaps in core Biology/Chemistry content?

Step 3 – Build a study plan

Rough guidance:

If you already have strong science and logic: 3–4 months of focused IMAT practice.
If your science is rusty or you come from a non-science track: 6–9 months with a heavier focus on building the basics.

Focus more time on:

Biology and Chemistry (together they are 38 questions),
Physics & Mathematics if you’re weak there,
plus at least weekly drills for Logic and Reading & GK.

Step 4 – Mix content study with timed practice

Good IMAT preparation is a mix of:

Content review (textbooks, notes, targeted explanations),
Past papers and full simulations,
learning to strategise under negative marking (when to skip, when to guess).

A common approach is:

2–3 months of content-heavy study with shorter question sets,
then 1–2 months of heavy mock exam practice, adjusting strategy.

9. IMAT preparation with polimitestprep

At polimitestprep, we specialise in entrance tests for Italian universities – from ARCHED and TIL-A for Architecture to CEnT-S and TIL-I for Engineering – and now we also help students who want to enter Medicine in Italy in English through IMAT.

Our IMAT preparation course is taught entirely in English and is designed for international students who:

want a clear 6-month plan,
need structured support in Biology, Chemistry, Physics/Maths and Logic,
and appreciate small-group, live online lessons with personalised feedback.

Details about the course will be published in the coming days! If you’re interested in preparing for the IMAT exam with us, please fill out the early interest form here.