The Preclinical Years: What You Actually Study in Years 1–3 of Medicine Abroad

What do you actually study in the first year of medicine abroad?

Mostly the sciences that medicine is built on, plus the opening block of anatomy. At the Medical University of Varna, the 2025/2026 curriculum for the English-language Medicine programme gives first-year students physics, chemistry, human biology, cytology with general histology and embryology, Latin with medical terminology, and Human Anatomy and Histology. Clinical subjects appear nowhere in that list.

The credit weights say a lot about priority. Varna's winter semester of year one gives physics 7 ECTS across 30 lecture and 60 seminar hours, and cytology with general histology and embryology another 7 ECTS across 50 lecture and 40 seminar hours. Human Anatomy and Histology starts small in that first semester — 5 ECTS, 15 lecture hours, 30 practical hours — and then expands.

Cluj-Napoca front-loads anatomy harder. The published Medical Curriculum for 2025–2026 at the University of Medicine and Pharmacy Iuliu Hațieganu gives first-year students General Anatomy and Embryology with Topographic and Sectional Anatomy at 10 ECTS and 140 hours, split 56 lecture hours to 84 practical hours. Biochemistry and physiology both begin in the second semester there, at 5 ECTS and 42 hours each. The whole first year at Cluj is 60 ECTS and 804 hours.

How many ECTS does anatomy carry, and how long does it run?

Longer than most people expect. Anatomy is rarely a one-year subject at European faculties. At Varna it runs from semester one to semester four; at the Medical University of Plovdiv the same pattern holds, with Human Anatomy and Histology taught across semesters one to four for a combined 90 lecture hours and 225 practical hours, worth 27 ECTS in the curriculum valid from 2026/2027.

Varna's split across those four semesters is 5, 10, 6 and 9 ECTS — 30 in total, against 120 lecture hours and 225 practical hours. Rīga Stradiņš University in Latvia states the subject differently again: its Medicine programme page lists Human Anatomy including Dissection Course at 15 ECTS and Histology separately at 10 ECTS, within a 360 ECTS, twelve-semester degree.

The Belgrade figures come from the faculty's own Anatomy course page, which describes 135 classes per semester across two semesters: 60 lecture, 60 laboratory and 15 seminar classes in the first, then 45 lecture, 60 laboratory and 30 seminar classes in the second.

How much of the week sits in labs rather than lecture halls?

Roughly half, and in anatomy often more. Cluj publishes the split directly. In its 2025–2026 curriculum, first-year anatomy is 56 lecture hours against 84 practical hours — practicals outweigh lectures by three to two. Second-year histology is an even 56 and 56. Physiology tilts the other way at 84 lecture hours to 70 practical hours.

Semmelweis University states it as weekly load. In the 2026–2027 Medicine curriculum, Macroscopic Anatomy and Embryology I in semester one is 2 lecture hours and 6 practical hours per week; in semester two it becomes 4 lecture hours and 6 practical hours. Medical Physiology I and II each sit at 6 lecture hours and 5 practical hours a week. Pathology I and II are 4 and 4.

What happens in the dissection room?

Students work with human donors, in small groups, over months rather than days. Rīga Stradiņš University names the facility plainly in its 2025 programme brochure — an Anatomicum with cadavers — and states an average study group size of 16. Its anatomy subject is titled Human Anatomy including Dissection Course.

The University of Belgrade describes the purpose in its own words on the Anatomy course page: the dissection laboratory offers an introduction to the variability of the human body and the uniqueness of each cadaver. That sentence is worth sitting with. Textbook illustrations show one idealised body; donors show the range that real bodies occupy, which is the reason the room exists.

Access is scheduled, not open. Laboratory sessions run to a timetable, which is why most students build a second layer of study around models, atlases and slide collections outside those hours. Every student placed through Medschool Experts receives an anatomical skull model and a white coat at the start of their studies as part of the standard equipment set — that is our own placement practice, not a university requirement.

What does year two add?

Biochemistry, physiology and microscopic anatomy, at a heavier credit weight than anything in year one. At Varna in 2025/2026, second-year students carry Biochemistry at 7 then 9 ECTS across the two semesters, Physiology at 8 then 9, and Human Anatomy and Histology at 6 then 9. Anatomy's final examination falls at the end of the summer semester of year two, after four semesters of teaching.

Cluj's second year is 60 ECTS across 972 hours. Physiology there is the single largest subject at 10 ECTS and 154 hours. General and Clinical Microbiology arrives already in year two at 9 ECTS and 126 hours, earlier than at most of the other faculties in this comparison. Histology is 8 ECTS and 112 hours, and Medical Genetics 7 ECTS and 98 hours.

At Semmelweis, Medical Physiology I and II each carry 11 credits — the largest single subject weight in the whole preclinical block of the 2026–2027 curriculum.

When do pathology, pharmacology and microbiology arrive?

Year three at most faculties, and they change the register of the degree. Varna places General Pathology in the winter semester of year three at 4 ECTS, 60 lecture and 30 practical hours, with Microbiology at 5 ECTS and Pathophysiology at 4 ECTS alongside it. Pharmacology follows in the summer semester of that year at 5 ECTS across 30 lecture and 45 practical hours.

Cluj compresses more into year three: Pathologic Anatomy at 8 ECTS and 140 hours, Physiopathology at 8 ECTS and 112 hours, Pharmacology at 8 ECTS and 70 hours, Hygiene at 7 ECTS. That year totals 60 ECTS across 986 hours, the heaviest of the first three at that faculty.

Plovdiv is the outlier worth noting. In the curriculum valid from 2026/2027, Pharmacology and Clinical Pharmacology sits in semester seven — year four — at 75 lecture and 75 practical hours, while Pathological Anatomy and Cytopathology spans semesters five and seven for a combined 90 lecture and 120 practical hours and 11 ECTS. Two faculties in the same country can order the same subjects differently.

Rīga Stradiņš lists its year-three preclinical block as Medical Microbiology and Immunology at 12 ECTS, Pathology at 12 ECTS and Pharmacology at 9 ECTS, with Basics of Surgery at 4 ECTS in the same stretch.

What do preclinical exams actually look like?

Three formats recur: a continuous assessment during the semester, a practical exam on specimens or slides, and a final theoretical exam. The mix differs by faculty, and it is written into the regulations rather than left to the department.

Belgrade publishes the arithmetic. Its Histology and Embryology course awards a maximum of 100 points: 50 for a final test of 100 multiple-choice questions, 20 for a practical microscope exam in which students identify ten slides and must name at least six correctly, 20 for three colloquia of 20 questions each, and 10 for attendance and activity. Fifty-one points is the pass mark, and the faculty's 2024 Rulebook sets that as grade 6 on a scale running to 10.

Colloquia are the part outsiders miss. They are assessments held during the semester, and passing them is often a condition of sitting the final exam at all. The Medical University of Varna's student handbook states that planned colloquia cannot exceed two per discipline per semester, and that without passing them a student cannot obtain certification in that subject. Belgrade's 2024 Rulebook allows up to four colloquia per preclinical course. Belgrade's Pathology department published its first colloquium of the year for 7 December 2026, covering general pathology and neoplasia.

Oral examination is written into the Romanian regulations rather than assumed. The ECTS guide of the Faculty of Medicine at Cluj-Napoca states that the final forms of examination are the theoretical exam and the practical exam, and that where practical testing is not feasible because of the nature of the subject, an oral final evaluation is organised instead. Semmelweis marks certain subjects as a comprehensive examination — Macroscopic Anatomy and Embryology II, Medical Biochemistry II, Medical Physiology II, Pathology II and Pharmacology II all carry that designation in the 2026–2027 curriculum.

Attendance is assessed too. Belgrade's Rulebook permits one missed exercise per semester without a makeup; missing more than a third of practical classes means the semester cannot be certified.

When do you first meet a patient?

Earlier than the phrase "preclinical years" suggests. Belgrade runs Basics of Clinical Practice I in the first year, worth 2 ECTS, taught practically in surgical departments at teaching centres. Students take vital signs, complete patient documentation, give oral and parenteral medication and prepare intravenous drugs. It closes with a colloquium graded pass or not passed.

Rīga Stradiņš places Introduction to Clinical Medicine and Patient Contact at 6 ECTS in year three, and states that students work with patients from the third year onward. Varna's handbook puts it in the same place: teaching from the third year onward takes place in clinical settings and involves work with patients. Its third-year curriculum backs that up with Propaedeutics of Internal Medicine at 6 ECTS per semester across 30 lecture and 90 practical hours, plus General and Operative Surgery.

Hungary starts the habit even sooner. Semmelweis includes Introduction to Patient Care in semester two at 2 credits, followed by a one-month Summer Practice in Nursing worth 3 credits and assessed by a practical exam. Introduction to Clinical Medicine follows in semester three.

What does a semester actually look like, month by month?

Varna publishes its academic calendar, which gives a concrete shape to years one to three. These are the 2025/2026 dates.

Three sittings per exam is the Bulgarian pattern. Varna's handbook grants full-time students three sittings for a semester examination — the regular, resit and liquidation sessions. Cluj works on a similar principle with a different rule set: three attempts a year across four sessions, and years one to three are validated with a minimum of 50 of the 60 credits, while years four to six require all 60.

What does the preclinical phase cost beyond tuition?

Published figures exist for the parts universities charge for, and those are the ones worth planning around. Books and instruments are the rest.

A worked example makes the shape clearer. Take a first-year student at Cluj-Napoca in 2026–2027 who passes everything except one 5-ECTS subject, and needs a third attempt at it. The third attempt costs 150 RON. Carrying those 5 credits into the next year costs 5 × 235 RON, so 1,175 RON. Enrolment adds 150 RON. That is 1,475 RON in published university charges on top of tuition — and the same student who passes at the first or second attempt pays only the 150 RON enrolment fee. The published rules reward finishing a subject in its own year.

Books are the other line. Belgrade names its histology set openly: Junqueira's Basic Histology in its 16th edition and The Developing Human: Clinically Oriented Embryology in its 11th. Anatomy usually needs an atlas alongside the textbook, and histology needs nothing extra because the microscopes belong to the institute. Students placed through Medschool Experts receive a white coat, an anatomical skull model, a suture training kit and a reflex hammer at the start of their studies, which covers part of the instrument list — that is our own arrangement and not something any university provides. The full contents are listed on our services page.

What do other articles about the preclinical years leave out?

Four things, consistently.

The first is that curricula inside one country differ. Varna and Plovdiv are both Bulgarian public medical universities, and their treatment of pharmacology is not the same: Varna teaches it in the summer semester of year three, Plovdiv in semester seven. Anyone comparing countries rather than faculties is comparing the wrong unit. Our partner university overview is organised by faculty for exactly that reason.

The second is that the total ECTS number is not comparable across borders. Belgrade, Cluj-Napoca, Rīga Stradiņš and Semmelweis all publish 360 credits for the six-year degree. The Medical University of Plovdiv publishes 301.0 ECTS and 5,174 academic hours for its Bulgarian-track programme in the curriculum valid from 2026/2027, with different totals for students in the English-language track. Neither figure is wrong; they count different things.

The third is the continuous assessment. Most descriptions of medicine abroad jump straight from lectures to the final exam and skip the colloquia in between, which is where a large share of the semester's work actually lands.

The fourth is that the practical exam is a separate obstacle with its own rules. Belgrade's histology practical requires six correct identifications out of ten slides. Its physiology practical draws two tasks from a bank of 70 covering injections, blood analysis, cardiac recordings and respiratory measurements. And pathology students there attend mandatory autopsy sessions — three at the Institute of Forensic Medicine in semester six. None of that shows up in a credit total.

How does the preclinical phase connect to what comes next?

Directly, and by design. Pathophysiology and pathology in year three explain the mechanisms that internal medicine describes in year four. Pharmacology in year three or four is the vocabulary of every therapeutic decision made from then on. Cluj states the split cleanly in its ECTS guide: 180 credits for years one to three and 180 for years four to six, one half of the degree on each side of the line.

Semiology is where the hinge sits at Romanian faculties. Cluj's third year includes Medical Semiology at 5 ECTS plus a further 6 ECTS of cardiovascular, digestive and haematopoietic semiology, and 7 ECTS of surgical semiology — the skills of taking a history and examining a patient, taught before the specialty rotations start. What that looks like in practice is covered in the companion article on the clinical years 4 to 6. Accounts from students at different stages are collected in our student stories.