Failing Medical School in Tunisia? What to Do When Your Inscriptions Run Out (2026)
02.10.2026
Short answer
Failing medical school in Tunisia? Four inscriptions used in the first cycle or a cap in the second: what happens now and how a transfer brings you back.
Four inscriptions
In short: Government Decree 2019-341 of 10 April 2019 sets the frame for medical studies in Tunisia. The first cycle (PCEM) lasts two years, and students may enrol in it no more than four times. Two years of study and two repeats are the maximum. After the fourth inscription without success, your place in Medicine is gone.
The four inscriptions are counted across the whole first cycle, not per year. Whoever repeats the first year twice has no reserve left for the second. Inscriptions are annual, and a student who does not renew in time is removed from the lists.
Second cycle
In short: The second cycle (DCEM) lasts four years: three years of externship and one internship year with four rotations of three months each. Inscriptions are unlimited in principle. Once a student passes seven inscriptions, the faculty council can examine the file and set a threshold that may not be exceeded, with a reasoned opinion.
Seven inscriptions for four years sound generous. But the decision is individual, and after it every further failure can be the last. The national exam for entry to the third cycle follows at the end, and the national diploma of doctor of medicine comes only after two more years of family medicine and a thesis, eight years in total.
Exams and clerkships
In short: Both years of the first cycle and the first three years of the second end with a final exam in two sessions, a main session and a catch-up session. To pass a year you need an average of at least 10 out of 20 in every certificate and all clerkships of the year validated.
A repeat year costs more than the failed certificate. Students who repeat must do and validate all clerkships of that year again. The certificate of the first cycle and the diploma of the second cycle are awarded only to students with no outstanding credit.
Derogation
In short: A derogation gives the right to one further, exceptional inscription. It is decided on your file, and it is not a right. If it is refused, studying Medicine in a Tunisian public faculty is over for you.
Apply with documents for illness or family reasons and with your results from the years you passed. Request your transcripts and clerkship attestations at the same time, whatever the outcome.
Free transfer consultation
Last inscription running? Check your options before the final session
We transfer you to medical schools abroad. In a free consultation we check which of them accept your passed certificates and plan your route back to Tunisia.
Book a free transfer consultationWhy students get stuck
In short: Medical students in Tunisia who struggle rarely lack ability, they were oriented into Medicine with some of the best baccalaureate scores in the country. The usual reasons are burnout, depression or anxiety, a family crisis, exam anxiety and the weight of a system where every certificate has to reach 10.
Depression shows up quietly, as lectures replayed without taking in a word. It is treatable. A medical certificate also matters for your file, because it is what a derogation is decided on.
None of this means you chose the wrong profession. I started dental medicine in Sofia in 2015, at 24, years after most of my classmates, and graduated in 2021. A slower start says nothing about the doctor you will become.
Switch early
In short: If exams keep going wrong, switching university is often the better move, and the earlier the better. A transfer while you are still enrolled and your passed certificates are recent saves time and stress.
- You are on your third or fourth inscription in the first cycle.
- You have passed seven inscriptions in the second cycle.
- The faculty council has set a cap for you.
- You have applied for a derogation or it was refused.
If one of these applies to you, book a free transfer consultation now rather than after the catch-up session.
Next four weeks
- Week 1: count your inscriptions in the current cycle and read the internal regulations of your faculty.
- Week 1 to 2: request your transcripts for every year and the attestations of all validated clerkships.
- Week 2 to 3: collect the programme with hours for each passed certificate. A receiving university credits only what it can compare.
- Week 3 to 4: see a doctor if health plays a part, and keep the documents for the derogation file.
- Before the last session: book a free transfer consultation and compare staying with a transfer and a planned return to Tunisia.
Transfer abroad
In short: A transfer from a Tunisian faculty to an English-taught medical school in Europe is possible, and Medschool Experts organises it. The receiving university assesses your transcripts and certificate programmes. Which universities fit you, and which year you can enter, depends on your profile.
A study transfer is a complicated undertaking. Every university checks hours, content and syllabi in its own way, and the documents have to arrive in exactly the right form. Our experts have almost ten years of experience with study transfers, and we regularly achieve placements into higher years, at times Year 4 or Year 5.
For Tunisian students the place abroad comes with a student visa. The admission letter, proof of funds and housing have to be ready in time, and we prepare that file with you.
Free transfer consultation
Transfer abroad, return to Tunisia: check your options
Send us your transcripts. We tell you which universities accept your certificates, which year you can enter and how your route back to Tunisia looks, step by step. Free and without obligation.
Check my transfer optionsReturning to Tunisia
In short: Yes, you can come back, but not automatically. A medical diploma from abroad needs an equivalence from the Ministry of Higher Education. The national and sectoral equivalence commissions decide on an individual basis and look at your whole school and university record. The commission can require an assessment exam, complementary training or both. After the equivalence you register with the Order of Physicians.
The criteria were revised by the ministerial order of 10 October 2023. Two points matter for a student who leaves now:
- Your baccalaureate counts: the commission looks at the whole record, starting with the baccalaureate, and not only at the final diploma.
- The Tunisian benchmark is eight years: the national diploma follows six years of study, two years of family medicine and a thesis. The commission compares your training with that path, clerkships included.
For specialists the rule is simpler: Tunisian doctors with a specialist diploma from abroad and at least five years of practice receive the equivalence without an exam and without complementary training. We choose your university so that its programme and clerkships can be documented and compared, and we tell you before you enrol what your return will look like.
Free transfer consultation
Plan your way back to Tunisia from day one
The equivalence commission will compare your whole training with the Tunisian one. We choose your university with exactly that in mind and show you the timeline in a free consultation.
Book a free transfer consultationCosts
In short: A public faculty in Tunisia costs almost nothing, but used-up inscriptions cost the whole degree. Tuition at European medical schools starts at about €3,500 a year, and living costs in many Central and Eastern European cities are €5,000 to €8,000 a year.
How we help
Medschool Experts reviews your transcripts and certificate programmes in a free transfer consultation, finds medical schools among our more than 25 partner universities that fit your profile, prepares the application and the documents, and plans your route back to Tunisia. More than 500 students have been placed so far. The first step is always a free transfer consultation.
The author's view
When I began dental medicine in Sofia in 2015, I was 24, years older than most of my classmates. I graduated in 2021, and today nobody asks how old I was in my first semester. Tunisian students who write to us often speak of their inscriptions like a countdown. The countdown belongs to one cycle in one system. Plan the next step while you still hold an inscription, because a student who is still enrolled gets transcripts and attestations without a fight.
Summary
In Tunisia the first cycle allows four inscriptions for two years of study, and the second cycle can be capped by the faculty council after seven. A derogation gives one exceptional inscription, and it is not a right. After that there is no place in Medicine at a public faculty.
A transfer to a medical school abroad is possible. The return needs an equivalence, decided case by case on your whole record. We plan that route home with you from the first day.
Conclusion
Do not sit your last session before you know your options. The transfer consultation is free, and it shows you which universities accept the certificates you have already passed and how you come back to Tunisia as a doctor. Book your free transfer consultation.
Failing medical school in Tunisia: 7 questions and answers
How many times can I enrol in the first cycle?
No more than four times for the two years of the first cycle.
Is there a limit in the second cycle?
Inscriptions are unlimited in principle. After seven, the faculty council can examine your file and set a threshold that may not be exceeded.
What do I need to pass a year?
An average of at least 10 out of 20 in every certificate and all clerkships of the year validated. There is a main session and a catch-up session.
What does a derogation give me?
The right to one further, exceptional inscription. It is decided on your file.
Can I transfer from a Tunisian faculty to a university abroad?
Yes. Medschool Experts organises transfers to English-taught medical schools in Europe. The receiving university assesses your transcripts and certificate programmes, and the year of entry depends on your profile.
Is a medical diploma from abroad recognised in Tunisia?
Not automatically. It needs an equivalence, decided case by case. The commission can require an assessment exam, complementary training or both.
Does the consultation with Medschool Experts cost anything?
No. The transfer consultation is free and without obligation.
What students say about Medschool Experts
Over 500 placements at 25+ partner universities across 10+ countries. See how our students experienced their path into medical school abroad in our student stories.
About the author
Marcel Kloos
Founder and owner of Medschool Experts, federally recognised dentist
Marcel Kloos is the founder and owner of Medschool Experts, a placement agency for medicine, dentistry, veterinary medicine and pharmacy degrees abroad. Since 2021 the team has secured more than 500 study places at 25+ partner universities in Europe and worldwide.
Study medicine abroad: Marcel's own path
Born in Stuttgart, Marcel started his degree late: at 24 he enrolled at the Medical University of Sofia, Faculty of Dental Medicine, and graduated in 2021 from the English-language programme. He went through the same steps his clients face today — nostrification of school certificates, entrance interviews, finding a flat in Sofia and later the recognition of a foreign degree. He is a federally recognised dentist.
What Marcel does at Medschool Experts
Today Marcel lives in Bern and runs Medschool Experts full-time. He visits every partner university in person, negotiates placement agreements directly with faculties and deans, and leads the free consultations in which applicants learn at which university they can start next semester. His YouTube channel on studying medicine abroad has helped thousands of applicants compare universities, costs and recognition.
Topics Marcel writes about
- Study medicine abroad independent of your high school diploma grades: universities, costs and admission
- Study dentistry, veterinary medicine or pharmacy in Europe in English
- Tuition fees and living costs at medical schools in Europe and worldwide
- Recognition of foreign medical degrees in the EU, Switzerland, the UK and the US
- Transferring between medical schools and returning home into a higher semester
All articles by Marcel Kloos are based on first-hand visits to the universities and conversations with current students. Book a free consultation to discuss your own path.
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