The IMAT exam is the one route into a medical degree taught in English at an Italian state university. It is a single paper test, sat once a year on the same day around the world, and your score on that afternoon decides everything: there is no interview, no personal statement and no weighting for school grades. For a non-EU student that sounds simple, but one rule changes the whole strategy and most guides bury it. If you live outside the EU, you do not enter the national ranking. You compete only for the handful of places reserved for non-EU candidates at the one university you named before the test, against everyone else who named the same one. Choosing that university well matters almost as much as your score. This guide is written from the Ministry's own decree for the 2026 test, its tables of places and venues, and the first non-EU ranking a university published this October. It covers what the test contains, how it is scored, how many places exist and where, how registration works, and what a candidate for September 2027 should be doing now. It is part of our guide to studying in Italy.
\nThe rules are set each year by ministerial decree. For the 2026/27 intake that was D.M. 1005 of 6 August 2026, and the format was identical to 2025, so it is a reliable basis for preparing.
\nThe paper has 60 multiple-choice questions, each with five options and one correct answer, to be completed in 100 minutes:
\nScoring is 1.5 points for each correct answer, minus 0.4 for each wrong answer and zero for a blank, giving a maximum of 90. Do the arithmetic before you plan your revision: biology alone is worth 34.5 points and chemistry 22.5, so those two subjects carry 57 of the 90 points. The reading and logic sections together are worth 13.5. A candidate who is strong in the sciences and average at logic will outscore the reverse every time. The penalty also matters. A blind guess among five options has an expected value just below zero, so guessing only pays once you can rule out at least one option.
\nIt is a paper test. The annexes to the decree describe sealed packs, a paper answer sheet read by an optical scanner, and a black pen supplied by the venue. All questions are in English. You do not need an English certificate to sit the test in general, because, as Bologna puts it, your English is assessed by the test itself. Certificates such as IELTS and TOEFL appear in the decree only as a tie-break between candidates on the same score, after the subject scores have been compared in the order biology, chemistry, physics and maths, logic, reading. Individual universities can ask for more: Milano Statale's 2026 call required non-EU applicants living abroad to upload a valid English certificate before the test, and excluded those who did not.
\nThere is a minimum score, and it differs by category. EU candidates, and non-EU candidates already resident in Italy, need at least 20 points to be ranked at all. For non-EU candidates living abroad the 20-point floor does not apply: the decree asks only for a score above zero. Do not read that as an easy bar. As the Bologna figures below show, the real threshold is set by competition, and it is very high.
\nPlaces are fixed in Table B of the decree, in two columns: one for EU candidates and non-EU candidates resident in Italy, and one for non-EU candidates resident abroad. The two quotas are separate. These were the non-EU places for medicine in English at state universities in 2026/27, largest first:
\nAdding those up gives 530 non-EU places in Italy at state universities. Tor Vergata also has 320 non-EU places on a course delivered in Tirana, Albania, which is a different proposition and should be read about separately before you choose it. Table B's printed total of 1,362 non-EU places for medicine also includes private universities, which this article does not cover; read each one's own call for how it admits and what it charges. For the other two degrees the numbers are small: dentistry in English had 6 non-EU places at Sapienza and 5 at Siena, and veterinary medicine had 5 at Bologna and 2 at Napoli Federico II.
\nTwo cautions on reading the list. Places change every year, sometimes sharply, so treat it as a guide to scale and not a forecast. And a large quota does not mean an easy entry: what matters is how many candidates choose that university, which the Ministry does not publish.
\nThis is the rule that decides most non-EU results. EU candidates list several universities in order of preference and are placed by a national ranking that moves down the list as places are accepted or declined. Non-EU candidates living abroad are treated differently. The decree states that their rankings \"are defined by the Universities\", and that each such candidate competes only in the local ranking of the one university where they filed their pre-enrolment application on the Universitaly portal. One university, chosen before you sit the test, with no second choice.
\nHow hard is it? The Ministry publishes no statistics, but universities publish their own non-EU lists. The University of Bologna had 20 non-EU places for 2026/27. Its first ranking, published on 26 October 2026, listed 570 eligible candidates. The top score was 86.60 out of 90. The twentieth and last winner scored 77.90, and the candidate in twenty-first place had the same 77.90 and missed out on the tie-break. In other words, a non-EU candidate needed at least 52 of the 60 questions right, and more if any answers were wrong, to win a place at Bologna on the first list.
\nThat is one university in one year, and Bologna is among the most popular. Lists do move afterwards as winners decline. But it shows the logic. With more than 28 eligible candidates for every place at Bologna, a score that fails there might have been comfortable at a university with three times the quota and fewer applicants. Since you cannot see other candidates' choices in advance, the best evidence you have is each university's published non-EU ranking from the previous year, which universities post on their admissions pages, as Bologna did on 26 October. Collect them before you choose.
\nRegistration is online only, on Universitaly, and the window is short. In both 2025 and 2026 it ran from 26 August to 9 September, closing at 15:00 Italian time. You complete it by paying a participation fee through the portal; the amount is set there and is not stated in the decree. At registration you choose the degree group, your university, and where you will sit the test.
\nYou do not have to travel to Italy to sit it. Table A of the decree listed test venues in 25 countries in 2026, including India, Pakistan, Turkey, Saudi Arabia, the United Arab Emirates (Dubai), Kenya, South Africa, Tunisia, China, Hong Kong, the United Kingdom, Germany, the United States and Canada, as well as 18 universities in Italy. Egypt and Nigeria were not on the list, so candidates there needed to travel to another country's venue. Exact addresses are published later, shortly before the test.
\nThe Ministry's IMAT page gives the 2026 sequence: test on 29 September, anonymous scores on 8 October, your own paper and score in your reserved area on 19 October, and rankings on 26 October. Places then had to be taken up within four days, and Bologna's non-EU winners had until 29 October to enrol and pay the first instalment. In 2025 and 2024 the test was on 17 September. So the working assumption for 2027 is a decree in the first week of August, registration from late August, and a test between mid and late September, with results and enrolment in October. None of that is confirmed until the 2027 decree appears.
\nOne more point, because it causes confusion. Italy reformed admission to medicine in 2025, replacing the entrance test for Italian-taught courses with an open first semester followed by a ranking. That reform does not touch the IMAT. The 2026 decree quotes the law directly: its provisions \"do not apply to courses delivered in English\". English-taught medicine keeps its test.
\nUniversitio checks your eligibility, helps you compare universities on their published non-EU places and rankings, and prepares the document pack with you so that an offer in October can be accepted in time.
\n \nIt is the single national admission test for medicine, dentistry and veterinary medicine taught in English at Italian universities. In 2026 it had 60 multiple-choice questions in 100 minutes, on paper, with a maximum score of 90. It is held once a year, on the same day in Italy and at venues abroad.
\nThe decree sets no minimum for non-EU candidates living abroad beyond a score above zero. The real threshold depends on the university you choose. At Bologna in 2026 the last of 20 non-EU winners on the first list scored 77.90 out of 90.
\nNo, not if you live outside the EU. You compete only in the ranking of the one university named in your pre-enrolment application. EU candidates, and non-EU candidates already resident in Italy, list several universities and are placed through a national ranking.
\nFor 2026/27, state universities offered 530 non-EU places for medicine in English on courses in Italy, by our addition of the Ministry's table. Individual quotas ran from 5 at Florence to 61 at Messina. Dentistry had 11 non-EU places and veterinary medicine 7.
\nNo date has been set. In 2026 the decree came on 6 August, registration ran from 26 August to 9 September and the test was on 29 September. In 2025 and 2024 the test was on 17 September, so expect mid to late September.
\nNot under the national rules. The test itself assesses your English, and a certificate counts only as a tie-break between candidates with equal scores. Some universities add their own rule, as Milano Statale did in 2026 for non-EU applicants living abroad, so read the call of the university you choose.
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