Is IMAT Compulsory for MBBS in Italy? 2026 Rules, Exceptions & What Changed

Yes, IMAT is compulsory if you want to pursue MBBS (Medicine and Surgery) in English at a public university in Italy. It is the only entrance exam accepted for these programs, and there is no way around it if you want a public, English-medium seat.

IMAT (International Medical Admissions Test) is Italy’s national entrance exam for Medicine and Surgery, Dentistry, and (since 2025) some Veterinary Medicine programs taught in English at public universities. It’s conducted once a year by Italy’s Ministry of University and Research (MUR).

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IMAT exists because Italian law requires a standardized, merit-based selection process for public medical education, open to both Italian and international candidates. There's no way to skip it and get a seat through interviews, personal statements, or management quotas at a public university offering the English-medium track. If you're asking how to apply for MBBS in Italy through the public system, IMAT registration is the first real step, not an optional add-on.

Scoring: +1.5 for a correct answer, -0.4 for an incorrect one, 0 for unattempted. This negative marking is heavier than NEET's, which is worth planning around if you're wondering whether IMAT is harder than NEET.

IMAT is held once a year, is open to Indian candidates at authorized test centres in India, and a score is valid only for that admission cycle.

If you've read that Italy "removed the entrance exam" for medicine, that's only half true, and getting this wrong is the single biggest mistake we see in this SERP right now.

In 2025-26, Italy introduced the Semestre Filtro (filter semester) as part of the Riforma Bernini. This reform:

• Applies only to Italian-taught Medicine and Surgery programs.
• Removes the old entrance test (previously TOLC-MED) for that track.
• Replaces it with open enrollment for one semester, followed by ranking based on Biology, Chemistry, and Physics exam scores (minimum 18/30 each) at the end of that semester.

This reform does not touch IMAT. English-medium Medicine, Dentistry, and Veterinary programs, the ones almost every Indian applicant is targeting, still require IMAT exactly as before. If you're specifically preparing for an English-medium seat, the filter semester is not a shortcut that is available to you.

Counselor insight: We've had students assume the Semestre Filtro means they can skip IMAT entirely and just enroll. That only works if you're comfortable studying in Italian from year one, but almost all Indian applicants aged 17-18 lack preparation for this due to no prior Italian instruction. Don't let this reform talk take pressure off your IMAT prep unless you've genuinely decided to go the Italian-medium route.

There are three real scenarios where you can pursue MBBS in Italy without IMAT:

1. Private universities. A handful of private Italian medical schools run their own entrance tests instead of IMAT. Fees are significantly higher, typically Rs. 11.1 lakh to Rs. 27.75 lakh a year (€10,000 to €25,000, at Rs. 111/EUR), against Rs. 1.11 lakh to Rs. 4.44 lakh a year at public universities. Always verify the current exchange rate before you budget, since this rate will move.
2. The Semestre Filtro route, if you're enrolling in an Italian-taught program and are prepared to study in Italian.
3. The Parificati (EU-equivalent) route, available only after you've held an Italian residence permit for a year, typically by first enrolling in an unrelated degree or language course. This is a multi-year detour, not a practical Year 1 alternative for most applicants.

If you're specifically searching for MBBS in Italy without IMAT, these are your only genuine options, and two of them involve real trade-offs in cost, time, or language.

Explore: MBBS in Italy

IMAT is the entry route at Italy's leading public medical universities, including Sapienza University of Rome, University of Milan, University of Bologna, University of Pavia, and University of Padua, along with Bari, Turin, Cagliari, Catania, Messina, and Marche (Ancona). At least 13 public universities currently offer IMAT-based English-medium Medicine, and the list keeps growing: the University of Florence launched its first fully English-taught Medicine and Surgery program for the 2026-27 cycle, taking the total higher.

• Completion of 10+2 (or equivalent) with Physics, Chemistry, and Biology, generally with at least 50% aggregate in PCB (40% for reserved categories, per general study abroad eligibility norms).
• Minimum age of 17 by the admission year.
• A valid passport and, later, a Type D student visa.
• Many universities waive IELTS/TOEFL for English proficiency if your prior education was in English; confirm this requirement per university.

Is MBBS free in Italy? Not entirely, but it's close for many students. Public university tuition typically ranges from Rs. 1.11 lakh to Rs. 4.44 lakh a year (€1,000 to €4,000, at Rs. 111/EUR), and Italy's DSU scholarship system reduces or waives fees entirely for students from lower-income families, based on ISEE income assessment, sometimes alongside subsidized or free hostel accommodation. This is a real reason Italy is genuinely competitive against other MBBS-abroad destinations for Indian applicants on a tighter budget.

Living expenses add roughly Rs. 66,600 to Rs. 1 lakh a month (€600 to €900, at Rs. 111/EUR). Always verify the live EUR-INR rate before finalizing your budget, since exchange rates shift and this figure will be out of date quickly.

The degree itself is a 6-year integrated program (LM-41, Medicina e Chirurgia), globally recognized and NMC-compatible for Indian graduates, provided the university is WHO-listed and the program structure meets NMC's requirements on duration, clinical training, and internship.

This is one of the most searched, and most incorrectly answered, questions on this topic. Here's the precise distinction:

• For admission to an Italian university: NEET is not required. IMAT is the only entrance exam Italian public universities use to select candidates, including international ones.
• For practicing in India after graduating: Indian students who complete an MBBS-equivalent degree abroad generally need to clear India's licensing screening exam (FMGE or NExT) to register and practice in India under NMC's Foreign Medical Graduate rules.

If your goal is to practice in India eventually, don't treat this opportunity as a footnote. Confirm the current NMC/FMGE requirement directly before you finalize your country choice.

Exact dates shift slightly year to year and are confirmed by MUR closer to the cycle, so treat the information as a planning guide and verify final dates on Universitaly before you commit to a preparation schedule.

Counselor insight: Most successful Indian IMAT candidates we've seen start focused preparation 6 months out, not because the syllabus is enormous, but because the negative marking punishes guesswork harder than NEET does. If you're coming from a NEET-prep background, the content overlap helps, but most students underestimate how much separate practice time the logical reasoning section needs.

For a fuller breakdown of fees, participating colleges, and the full application process, see our guide to MBBS in Italy fees and eligible colleges. If Italy's competitiveness feels like too narrow a bet, it's worth comparing MBBS destinations for Indian students before you commit a year to IMAT prep alone.

If your IMAT score falls short of your target university's cutoff, you're not automatically out. Options include:

• Ranking additional public universities where your score clears the cutoff, since seat competition varies significantly by institution.
• You could also apply to a private Italian medical school for the same admission year, since these run separate, often less competitive, entrance tests.
• Reattempting the following year, since IMAT is conducted annually and a single low score doesn't bar future attempts.

1. IMAT is compulsory only for public, English-medium MBBS in Italy. Confirm your target route (public vs. private vs. Semestre Filtro) before starting IMAT prep, since only one of these actually requires it.
2. Check university-specific IMAT cutoffs and seat counts against your realistic score range before committing 6+ months of preparation to a single university choice.
3. Verify the current NMC/FMGE-NExT requirement directly with NMC if practicing in India afterward is part of your plan, since this affects your decision as much as IMAT itself does.

Still deciding if IMAT is worth the prep? Talk to a LeapScholar counselor to check whether IMAT is compulsory for your specific MBBS in Italy shortlist and get a realistic prep timeline based on your target universities.