What is the difference between the IMAT and the Medicine entry test in the Italian language? Can I sit both?

If you want to study medicine in Italy, you’ve probably come across two different admission paths: the IMAT for English-taught programs and the Italian medicine admission process for Italian-taught courses.

Both lead to the same medical degree and both last six years, but the admission process, especially after the introduction of the new Italian “semestre filtro” (filter semester) system, is now quite different.

So what exactly changes between the IMAT and the Italian medicine admission system today? And most importantly: can you apply to both?

In this guide, we’ll explain:

• the difference between the IMAT and the Italian medicine admission process
• how the new filter semester works
• whether you can apply to both
• and which option may be better depending on your background and language level

What is the IMAT?

The IMAT is the entrance exam for English-taught medical schools in Italy.

Unlike the Italian medicine admission system, the IMAT still relies on a single national entrance exam before enrollment.

If you want a more detailed explanation of the IMAT structure, scoring system, subjects, and preparation strategies, check out this complete guide here.

What is the Italian Medicine Admission System (“Semestre Filtro”)?

The Italian-taught medicine admission system has recently undergone a major reform with the introduction of the so-called “semestre filtro” (“filter semester”).

Previously, students had to pass a national entrance exam before being allowed to enroll in medicine. Under the new system, students can initially enroll and attend the first semester of university courses before the actual selection takes place.

During this semester, they follow courses in Biology, Chemistry and Introductory Biochemistry, and Physics, for a total of 18 CFU. 

At the end of the semester, students sit three separate exams, one for each subject, all held nationally, on the same day across Italy. The exams follow a fixed order, with short breaks between them: 

1. Chemistry 
2. Physics 
3. Biology

Each exam lasts 45 minutes and contains 31 questions: 15 multiple-choice questions and 16 completion/open-format questions. 

The scoring system is also standardized:

• +1 point for each correct answer
• 0 points for unanswered questions
• -0.10 points for incorrect answers

Students are generally required to reach at least 18/30 in each subject, however, those who pass only two, or even just one, exam may still enter the national ranking, although with academic debts in the form of missing CFU that must later be recovered.

The final score contributes to a national ranking published on Universitaly, which ultimately determines admission based on the score you got and the available seats.

So while the old entrance exam technically disappeared, the competitive aspect of admission definitely didn’t. The pressure is simply distributed differently, this means the “filter semester” is not necessarily easier than the previous one, although some students may see this as a less stressful alternative to a traditional entrance exam.

IMAT vs Italian Medicine Admission: Main Differences

Language:

• IMAT → courses taught entirely in English
• Italian path → courses taught entirely in Italian

Studying medicine is challenging enough already; doing it in a language you are not fully confident with can make everything considerably harder over the course of six years, not just during admission.

And the difficulty goes far beyond the “filter semester” exams themselves. Students are expected to keep up with fast university lectures, study large amounts of scientific material, interact with professors and eventually patients, and pass both written and oral exams entirely in Italian.

Many students underestimate how different academic and medical Italian is from everyday conversation. Being able to communicate casually is often not enough to comfortably handle medical school.

For this reason, unless your Italian is already very solid academically, the IMAT is usually the more realistic option for most international students.

Admission route:

• IMAT → one national entrance exam
• Italian path → selection after the filter semester

At first, the Italian system may seem less stressful because there is no immediate admission test before enrollment. However, in reality, the competitive aspect of the admission process didn't change significantly. At the end of the filter semester, students still have to sit multiple exams, all concentrated on the same day. So while the IMAT concentrates the selection into one exam, the Italian path essentially spreads the preparation over several months before culminating in a highly competitive examination phase anyway.

Can You Apply to Both IMAT and the Italian Medicine Program?

Yes, in most cases, students can apply to both the IMAT and the Italian medicine admission path in the same academic year. In fact, Many people actually do this to keep more options open and increase their chances of getting into medical school in Italy.

However, there are several important differences to consider

For Italian Students

For Italian students, applying to both paths is often seen as a backup strategy.

Many students see the IMAT as a more straightforward and predictable selection process compared to the uncertainty of the new filter semester.

Another important difference is psychological: with the IMAT, the majority of the anxiety is concentrated into one exam day. With the Italian path, the competitive pressure continues for an entire semester through lectures, study sessions, and university exams before admission is determined.

For International Students

For international students, especially non-EU students, the situation is a bit more complex.

Technically, it is possible to apply to both admission systems. The real issue, however, is not simply getting admitted, but managing to complete an entire medical degree in Italian afterward.

The “semestre filtro” requires students to:

• attend university lectures entirely in Italian
• study scientific textbooks in Italian
• pass multiple university-level exams
• and interact with professors, hospital staff, and patients in Italian for all 6 years of medical school

This is very different from having a conversational level of Italian. Medical and scientific language can become extremely demanding very quickly.

For this reason, unless your Italian is already very strong academically, the IMAT usually remains the more realistic and sustainable option for international students who want to study medicine in Italy.

One advantage of preparing for both systems, however, is that many scientific subjects overlap.

Which Option is Better: IMAT or Italian Medicine?

There is no universal answer, it depends on your situation.

The IMAT may be better if:

• you prefer studying in English
• you are an international student
• you want a more internationally oriented environment
• or your Italian is limited

The Italian medicine path may be better if:

• you already speak Italian fluently
• you are comfortable studying complex subjects in Italian
• you wanna increase your chances of attending university in Italy

At the end of the day, both paths lead to the same qualification and the same profession.

What really matters is choosing the option that best matches your language level, study habits, and long-term comfort. Studying medicine is already demanding enough, being in the right environment can make a huge difference over the course of six years.

Frequently Asked Questions (FAQ)

Can I apply to both the IMAT and Italian medicine programs?

Yes, in most cases students can participate in both admission processes in the same year.

Can non-EU students apply to Italian-taught medicine programs?

Yes, although admission rules may vary and studying medicine in Italian requires a very strong language level.

Do I need an Italian language certificate for Italian medicine?

Requirements can vary depending on the university, but practical fluency is essential regardless of formal certification.

Is the IMAT still required for English medical schools in Italy?

Yes. English-taught medicine programs in Italy still require the IMAT.