IMAT 2026 Guide: Format, Scoring & Medicine in Italy
By Velacai · June 25, 2026 · 13 min read
What is the IMAT, and what does this guide cover?
The IMAT (International Medical Admissions Test) is the English-language entrance exam for English-taught undergraduate Medicine & Surgery, Dentistry, and (since 2025) Veterinary Medicine at Italian public universities. It is open to both EU and non-EU candidates, is sat entirely in English, and selects students by a single score on a 60-question multiple-choice paper. This guide is the definitive overview: who runs the IMAT now, why the 2025 Italian-language reform does not touch it, the exam format, scoring and ranking, which universities use it, and how to prepare.
If you want medicine in Italy taught in English, the IMAT is almost certainly your gateway. Let's break down everything you need to know for the 2025–2026 cycle.
Who the IMAT is for
The IMAT is designed for international students who want to study medicine (or dentistry, or veterinary medicine) in Italy but don't speak Italian at university level. The degrees are taught in English from day one, are fully recognised across the EU, and cost a fraction of medical school in the US, UK, or Ireland.
You should be looking at the IMAT if:
- You want a 6-year MD-equivalent ("Medicine & Surgery") degree taught in English.
- You're an EU citizen, a non-EU citizen living in Italy, or a non-EU citizen applying from abroad — all three groups can sit the IMAT.
- You have a secondary-school background in biology, chemistry, physics, and maths (the exam assumes high-school-level science).
There is no nationality restriction. What changes between groups is how you're ranked and how many seats you compete for, which we cover below.
Who runs the IMAT now (this changed — read this)
This is the single most misunderstood fact about the IMAT, so let's be precise.
The IMAT used to be developed in partnership with Cambridge Assessment. That is no longer the case. Since 2023, the IMAT has been administered by the Italian Ministry of University and Research (MUR), with CINECA as its technical partner. You register and apply through the Universitaly portal (universitaly.it), not through any Cambridge channel.
Every year, an official ministerial decree sets the dates, the available seats, and the rules for that cycle (for example, DM n. 599 of 7 August 2025). The decree is the authoritative source — whenever this guide gives a number or a date, the current decree on Universitaly overrides it.
Why did this happen? Cambridge withdrew from its medical-admissions testing business. In the UK, this killed the BMAT (its final sitting was October 2023, and UK universities switched to the UCAT). The IMAT, by contrast, didn't disappear — Italy simply moved it in-house to MUR/CINECA. The BMAT did not survive; the IMAT did.
The 2025 reform does NOT abolish the IMAT
In 2025, Italy introduced a major reform — the "semestre filtro" (filter semester), also called semestre aperto (open semester). It abolished the entrance test for Italian-language Medicine, replacing the old TOLC-MED test with an open first semester that filters students by exam performance after enrolment.
Here is the part that matters for you: this reform applies only to Italian-taught courses. The English-taught IMAT is unchanged. It still selects candidates by IMAT score and a merit ranking, and this has been confirmed for both 2025 and 2026.
In short: if you read somewhere that "Italy abolished its medical entrance exam," that headline is about the Italian-language track. The IMAT runs in 2025, runs in 2026, and continues to work exactly as described in this guide.
The IMAT format at a glance
The IMAT is a paper-based, pen-and-paper multiple-choice exam. It is not computer-adaptive, has no on-screen calculator, and has no typed/grid-in answers — every question is multiple choice with five options, and you can use only one of them.
You get 100 minutes to answer 60 questions. Here is the current (2024–2025) syllabus structure:
| Section | Questions |
|---|---|
| Reading Skills & General Knowledge | 4 |
| Logical Reasoning (problem solving) | 5 |
| Biology | 23 |
| Chemistry | 15 |
| Physics & Mathematics (combined) | 13 |
| Total | 60 |
A few things worth flagging:
- Biology dominates. At 23 of 60 questions (about 38% of the paper), biology is by far the biggest scoring opportunity. We'll come back to this.
- The sciences carry the exam. Biology + Chemistry + Physics & Maths = 51 of 60 questions. The "general" content (reading and logic) is now only 9 questions.
- This is a recent shift. Before 2024, the IMAT had a much larger general-knowledge and logic block (roughly 20+ "general" questions). The 2024 revision cut that down sharply and loaded the sciences instead — especially biology. The 2025 paper followed the 2024 structure.
The 2026 paper is expected to look similar, but the structure for any given year is only officially confirmed by that year's decree. For a deeper breakdown of each section, see our IMAT format and syllabus guide.
The five subjects, in depth
Biology — 23 questions
The largest section and the one that most often decides admission. Expect cell biology, biochemistry of the cell, genetics and inheritance, molecular biology (DNA, RNA, protein synthesis), human anatomy and physiology, reproduction and development, and ecology/evolution. Because it's worth so many marks, biology is where well-prepared candidates separate from the pack. Treat it as your priority subject.
Chemistry — 15 questions
The second-biggest section. Covers atomic structure and the periodic table, chemical bonding, stoichiometry, states of matter and solutions, acids and bases, redox reactions, thermodynamics basics, and a meaningful chunk of organic chemistry (functional groups, basic reactions, isomerism). Strong chemistry fundamentals also reinforce your biology.
Physics & Mathematics (combined) — 13 questions
Physics and maths are grouped into a single 13-question block, and the internal split between them varies from year to year — don't assume a fixed ratio. Physics covers mechanics, energy and work, fluids, thermodynamics, electricity and magnetism, and optics. Maths covers algebra, functions, basic geometry, probability, and proportional reasoning. Calculations are kept manageable because there is no calculator — questions reward clean reasoning over heavy arithmetic.
Logical Reasoning — 5 questions
Problem-solving questions that test how you handle information rather than what you've memorised: deductions, spotting the necessary conclusion, identifying assumptions, and simple quantitative puzzles. These reward practice with the question style more than content study.
Reading Skills & General Knowledge — 4 questions
The smallest section. Reading questions give you a passage and test comprehension, inference, and argument structure. General-knowledge items can be broad and are hard to "study for" efficiently — given there are only four, don't over-invest here at the expense of biology and chemistry.
How scoring and negative marking work
The IMAT uses negative marking, which changes how you should approach the exam:
- Correct answer:
- Wrong answer:
- Blank (unanswered):
The maximum score is 90.0 (). To enter the merit ranking at all, EU candidates need at least 20 points and non-EU candidates need more than 0.
The negative marking makes guessing strategy genuinely important. With five options, a completely blind guess has an expected value of:
That's slightly negative — essentially break-even, marginally worse than leaving the question blank. But if you can eliminate even one option (down to four choices), the maths flips positive:
Eliminate two options and it climbs to roughly per question. The takeaway: leave a question blank only when you truly cannot rule out anything; if you can eliminate even one option, guessing pays off on average. We go deep on this in the IMAT scoring and ranking guide.
How the merit ranking and quotas work
Getting a good score is only half the story — admission depends on where you land in the ranking and which seat pool you're competing in.
- EU candidates (and non-EU candidates residing in Italy) compete in a single national merit ranking managed through Universitaly. You list your preferred universities, and your score determines where you slot in nationally.
- Non-EU candidates residing abroad are ranked per university, against that specific university's reserved non-EU quota.
Admission then works through merit "scrolling." As assigned candidates enrol or decline their seats, the unfilled places reassign down the ranking in successive rounds. This means cut-off scores typically fall over the rounds — a score that doesn't get you in immediately may still succeed as the list scrolls.
Each university publishes separate EU and non-EU seat counts. Non-EU seats are generally scarcer, so non-EU cut-offs tend to run higher. Any specific seat numbers or cut-off figures you see are illustrative and change every cycle (and during scrolling) — always check the current decree and Universitaly for the real numbers. Full detail is in the scoring and ranking guide.
Which universities use the IMAT
Around 16 public universities offer English-taught Medicine & Surgery via the IMAT. The list includes:
- Sapienza University of Rome
- University of Bologna
- University of Milan (Statale)
- University of Milan–Bicocca
- University of Rome "Tor Vergata"
- University of Padua
- University of Pavia
- University of Campania "Luigi Vanvitelli"
- University of Messina
- University of Parma
- University of Bari
- University of Catania
- University of Cagliari
- University of Turin
- Marche Polytechnic University (Ancona)
- University of Naples "Federico II"
For a profile of each — the English-taught Medicine programme, the city, competitiveness and how to apply — see our IMAT universities directory.
A few private universities — Humanitas, San Raffaele, and UniCamillus — also offer English-taught medicine, but they admit through their own entrance tests, not the IMAT. If a programme is private, check its own admissions process rather than assuming the IMAT applies.
How to prepare for the IMAT
Your preparation should mirror the exam's priorities. Three principles do most of the work:
1. Make biology your centre of gravity
With 23 of 60 questions, biology is the highest-leverage subject on the paper. A candidate who is excellent at biology and merely solid elsewhere usually beats one who is balanced but average. Build deep, secure coverage of cell biology, genetics, and human physiology first — then layer in chemistry, then physics & maths.
2. Build a deliberate negative-marking strategy
Because of the penalty, you need a personal rule for when to answer and when to skip. The maths above gives the principle (eliminate one option → guess; eliminate nothing → consider leaving it blank), but it only becomes second nature through practice under real conditions. Don't discover your guessing instincts on exam day.
3. Practise full-length, under time
The IMAT is a pacing exam: 60 questions in 100 minutes is 100 seconds per question on average, including transferring answers. Doing untimed question sets builds knowledge but not exam stamina. Sit complete, timed mocks that mimic the real section mix and the real scoring. Practising with realistic IMAT practice — full-length, timed 60-question mocks that apply the official scoring — lets you rehearse pacing and guessing decisions before they count.
For a complete study plan, timeline, and resource list, see how to prepare for the IMAT. You can also compare plan options on our pricing page.
When is the IMAT in 2026?
The official 2026 date has not been announced yet. The IMAT is typically sat around mid-September, and the exact date for 2026 will be confirmed in that year's ministerial decree, published on Universitaly. Plan your preparation around a mid-September target and watch the decree for the official date and registration deadlines.
FAQ
Is the IMAT still happening in 2026?
Yes. The 2025 Italian reform (the semestre filtro) only affected Italian-taught Medicine. The English-taught IMAT is unchanged and confirmed for both 2025 and 2026. It is administered by MUR/CINECA and you register through Universitaly.
Is the IMAT the same as the BMAT?
No. They were both once linked to Cambridge Assessment, but the BMAT was discontinued (its final sitting was October 2023) and UK universities moved to the UCAT. The IMAT survived by moving to Italy's MUR/CINECA and remains the entrance test for English-taught medicine in Italy.
How many questions are on the IMAT and how long is it?
The IMAT has 60 multiple-choice questions to be answered in 100 minutes, with five answer options each. The current breakdown is 23 biology, 15 chemistry, 13 physics & maths, 5 logical reasoning, and 4 reading skills & general knowledge.
What score do I need to pass the IMAT?
There's no fixed pass mark — admission depends on the merit ranking. To enter the ranking, EU candidates need at least 20 points and non-EU candidates need more than 0 (out of a maximum of 90). The real cut-off depends on the number of seats, the candidates that year, and scrolling. See the scoring and ranking guide for detail.
Can non-EU students take the IMAT?
Yes. Non-EU candidates can sit the IMAT. If you reside in Italy you're ranked in the national EU-track ranking; if you apply from abroad you compete per university against that university's reserved non-EU quota, which is usually smaller (so non-EU cut-offs tend to run higher).