What Is the IMAT? Italy's English-Taught Medicine Entrance Exam Explained (2026)

What is the IMAT exam?

The IMAT is the national entrance test for the English-taught degree programmes in medicine and surgery, dentistry and veterinary medicine at Italian public universities. It was introduced in 2011, and in 2026 the Italian Ministry of University and Research runs it. One score, one national ranking, one sitting a year.

Italy limits the number of medical study places by law. Every year the ministry sets how many places each university may fill in its English-taught programme, and the IMAT score decides who gets them. The Italian-taught programmes no longer use a classic entrance test since 2025, so the IMAT now stands on its own as the test route into Italian medicine.

Around 17 public universities offer English-taught medicine in 2026, from Milan, Pavia and Padua in the north to Rome, Naples, Bari and Messina further south. Private universities in Italy run their own admission tests, separate from the IMAT.

Who sits the IMAT in 2026?

Three groups sit the IMAT in 2026: Italian and other European Union citizens, non-EU citizens who legally live in Italy, and non-EU citizens applying from abroad. The first two groups share one national ranking. Non-EU applicants living abroad compete in a separate ranking for the places reserved for them at each university.

That split matters. A student from Italy, Greece or Germany competes nationally against everyone else in the EU group, and places move through the ranking as candidates accept or decline. A non-EU applicant from abroad competes for a small contingent at one chosen university, and that ranking does not move between universities.

Most candidates are school leavers. Many are sitting it for the second or third time. Repeat candidates are normal here.

How is the IMAT 2026 structured?

The IMAT 2026 has 60 multiple-choice questions with five options each and lasts 100 minutes. A correct answer earns 1.5 points, a wrong answer costs 0.4 points and a blank earns nothing, so the maximum is 90 points. Biology and chemistry make up 38 of the 60 questions.

The section weights changed over the years. Earlier versions gave more space to logic and general knowledge, while the 2026 version is heavily science-based, which brings it close to the content of a final school year in biology, chemistry, physics and mathematics. Tactics are not the subject here. The structure is.

When is the IMAT in 2026?

The IMAT 2026 takes place at the end of September 2026, on one day, in test centres in Italy and abroad. Registration runs through the Universitaly portal from late August to early September 2026. Anonymous results follow in early October, and the named national ranking is published later in October.

Non-EU applicants living abroad also go through a pre-enrolment on Universitaly in spring and summer, often before the visa application. The exact dates come from the ministerial decree each year and differ by university for that step.

The timing has one practical effect. Many European medical faculties begin teaching in late September or early October. A candidate who waits for the IMAT ranking before deciding often finds that the semester abroad has already started.

How competitive are the English-taught programmes in Italy?

The English-taught programmes in Italy are among the most competitive in Europe in 2026. In 2025, 13,495 candidates sat the IMAT for about 1,050 places in the national ranking, roughly 13 candidates per place. The last place in medicine in the first 2025 allocation went to a score of 54.8 out of 90.

Two numbers explain the pressure. Candidate numbers grew by almost a quarter between 2024 and 2025, while places stayed in the same range. And tuition at Italian public universities is income-based, often a few hundred to a few thousand euros a year, which makes the programmes attractive far beyond Italy.

A good score is often not enough. In 2025 a candidate could answer well over half of the questions correctly and still miss medicine by a wide margin.

What happens if your IMAT score is not enough?

If an IMAT score is not enough for a place in 2026, the candidate can wait for the ranking to move, sit the test again in September 2027, or start this academic year at a European university where the place does not depend on a test score. Each option has a cost in time or money.

Waiting for movement in the ranking can work for scores close to the cut-off. It rarely works for scores far below. Sitting the test again means a full year without study progress, because the IMAT has one sitting per year. Many candidates take a gap year with preparation courses and then face the same odds.

The third option keeps the year. Students start medicine in English at a state-accredited European university, sit the same kind of anatomy and physiology exams as students in Milan, and graduate with a diploma recognised across the European Union. Some later move into an Italian programme in a higher year. Medschool Experts is the leading expert worldwide in credit recognition and frequently achieves placement into year 4 or year 5 at top universities. The details are on the university transfer page.

Is there a medical school in Europe that does not depend on a test score?

Yes. At the 25+ partner universities of Medschool Experts in 2026, the study place does not depend on a test score or on high-school diploma grades. The partner faculties in Bulgaria, Serbia, Bosnia and Herzegovina, Poland, Czechia, Hungary, Romania and Malta teach medicine in English and award EU-recognised or internationally recognised degrees.

Some partner universities run their own short admission interview or test. Medschool Experts does not make that a big topic, because the placement decision rests on the whole profile and the work Medschool Experts does with the faculty. Which university fits depends on your profile. Book a free consultation and we look at it together.

What does the European alternative cost?

A six-year medical degree at the Medical University of Pleven in Bulgaria costs about 100,000 euros in 2026, living costs and flights included. Tuition is 9,000 euros a year, so 54,000 euros over six years. Living costs of around 600 euros a month add 43,200 euros, and four return flights a year add about 2,880 euros.

Medicine in Italy costs less in tuition. That is a fact, and it belongs in the comparison. Against it stand the years. A candidate who sits the IMAT twice and misses twice has lost two years, and a doctor's salary at the end of the training is worth more than the tuition difference for most people. The Medical University of Sofia, the Medical University of Plovdiv and the Medical University of Varna charge 10,000 euros a year, while faculties in Serbia and Bosnia and Herzegovina are below that.

One limitation is real. English-taught programmes abroad include the local language for the clinical years, because patients speak it. In Bulgaria that means several hundred hours of Bulgarian over the first three years.

Is a European medical degree recognised in Italy?

Yes. A medical degree from a university in another EU member state is recognised automatically in Italy under Directive 2005/36/EC, as long as the programme meets the directive's minimum of five years and 5,500 hours. In 2026 that covers medical diplomas from Bulgaria, Romania, Poland, Czechia, Hungary and Malta.

Graduates register with the Italian medical association and can apply for specialist training through the national competition like any graduate from Rome or Bologna. Degrees from Serbia or Bosnia and Herzegovina follow a separate recognition procedure in Italy, which is a planned step and not an automatic one.

International perspective: how this works in other countries

Italy is not alone in using a single national test. In the United Kingdom, most medical schools ask for the UCAT, an aptitude test sat in summer, together with A-level grades and an interview. In Austria, the public medical universities in Vienna, Graz, Innsbruck and Linz select through one joint test, the MedAT, held once a year in July, with several applicants for every place.

Germany combines school grades with an aptitude test and waiting-time quotas, and most places still go to applicants with near-perfect school results. In the United States, medicine is a graduate degree, and the MCAT is taken after a four-year bachelor's degree. Spain uses the national university entrance score from the end of school, and Greece uses the Panhellenic exams.

The pattern is the same in all of them. Places are limited, a single score or grade decides, and the result arrives once a year. That is why thousands of students from Italy, Germany, Austria, Greece, Sweden and the Gulf states choose English-taught programmes in Central and Eastern Europe every autumn. The diploma is the same EU diploma. The route into it is different.

How do you decide between another IMAT and starting abroad?

The decision between a second IMAT and a start abroad in 2026 depends on three things: how far the first score was from the cut-off, how much a lost year costs you, and whether you want to return to Italy during or after the degree. A score within a few points of the last admitted candidate is a different situation from a score 20 points below.

Students who start abroad can still aim for Italy later. Many Italian students do exactly that, either through a move in a higher year or by coming back after graduation to work. Compare the faculties on the universities page, then talk to us. Medschool Experts tells you which of the 25+ partner universities can start you this year.