Lessons of the filter semester (semestre filtro, the first-semester route that now decides admission to Medicine and related degrees in Italy) started on 1 September, and today is Saturday 19 September: two and a half weeks of the course behind us. The first exam sitting is on 10 December at 11:00, the second on 11 January 2027. From today to 10 December there are exactly twelve weeks. I have already written guides for Chemistry and for Physics: Biology was missing, and for many it is the subject they feel most confident about — wrongly, because “I know the topic” and “I answer well in 90 seconds” are two different things.
One point needs clearing up straight away, because I often see it confused by people who write to me: this is not a post about the TOLC-MED. If you are preparing for that test, with its logic and general knowledge section, the right guide is the one on cell and molecular biology for the medicine admission test. Here we are talking about a university exam worth 6 ECTS credits, with a course syllabus, attendance and two exam sittings: you prepare for it as you prepare for an exam, not as you prepare for a multiple-choice test.
How the exam is structured
Every subject of the filter semester has its own separate exam: 50 minutes, 31 questions — 21 multiple-choice and 10 fill-in. No logic, no general knowledge, no English. Structure, duration and number of questions are set by Ministerial Decree (DM MUR) no. 941 of 10 July 2026; the dates by Directorial Decree no. 249 of 13 July 2026. The admission mechanism comes from Law no. 26 of 14 March 2025 and Legislative Decree 71/2025: free enrolment via Universitaly within the limits of the places available, attendance of three courses worth 6 ECTS credits each (Chemistry and preparatory biochemistry, Physics, Biology), two exam sittings per subject, then a national merit ranking.
The scoring is set by art. 8 of DM 941/2026: +1 for every correct answer, 0 for every omitted one, −0.1 for every wrong one, up to 93 points across the three exams; each exam is marked out of thirty and is passed with at least 18/30. The 21 multiple-choice questions have five options, only one correct (Annex 2). The penalty is small: guessing at random among five options is worth on average points, so, unlike the TOLC tests with their −0.25, on multiple-choice questions leaving a blank does not normally pay.
The places for 2026/27 (DM no. 1004 of 6 August 2026) are 30,225 in total — 27,001 Medicine, 1,825 Dentistry, 1,399 Veterinary Medicine — against about 62,200 enrolled in the filter semester. For Medicine, the figure is about 18,889 places assigned through the national ranking. As for what happens to those left out of the ranking — the move to a related degree — the right source is the decree and your own university’s website: it is not a procedure I will summarise here without being sure of every detail.
Fifty minutes for 31 questions is less than 100 seconds per question. Keep it in mind as you read the syllabus: it decides how to study it, not only what to study.
The syllabus, block by block
1. The cell
Prokaryotes versus eukaryotes, plasma membrane and transport (simple and facilitated diffusion, osmosis, active transport, the sodium-potassium pump), organelles and their function, cytoskeleton. It is the foundational block: if the membrane and transport are not automatic, every later question on water balance or cell signalling starts uphill. It deserves the first two weeks, with no rush to move on.
2. Biomolecules
Carbohydrates, lipids, proteins (primary, secondary, tertiary and quaternary structure, and denaturation), nucleic acids, enzymes and qualitative kinetics — active site, competitive and non-competitive inhibition. A compact block, very definitional: it is best studied with comparative diagrams (the four classes of biomolecules side by side) rather than by reading the book in a straight line.
3. Metabolism and energy
ATP, glycolysis, the Krebs cycle, the respiratory chain and the energy balance, lactic and alcoholic fermentation, photosynthesis in outline. It is the block where the most time is wasted memorising intermediates that are rarely asked, while almost all the score is decided on the energy balance and on location (cytoplasm or mitochondrion, matrix or inner membrane). One of the two exercises below is on exactly this.
4. Cell division
Cell cycle, mitosis phase by phase, meiosis and crossing over. The distinction that is always asked — because it lends itself to quick, unambiguous questions — is the number of daughter cells, the chromosome complement and where genetic variability comes from. A short block but with a very high yield: a few hours of targeted study cover a disproportionate share of the possible questions.
5. Genetics
Mendel’s laws, Punnett squares, incomplete dominance and codominance, ABO blood groups, multiple alleles, sex-linked traits (X-linked), linkage. Together with cell division it is the most “mathematical” block of biology: the questions have a single computable answer, not an interpretation, and for that very reason they are trained with exercises more than with theory.
6. Molecular genetics
DNA and replication, transcription, the genetic code, translation, mutations, gene regulation (the lac operon as the classic example), a mention of biotechnologies such as PCR. Here the risk is learning the definitions without the mechanism: knowing that “transcription produces RNA” is not enough if a question then asks what happens downstream if a transcription factor does not bind.
7. Human anatomy and physiology
The main systems — cardiovascular, respiratory, digestive, nervous, endocrine — in outline, not in the detail of an anatomy textbook. What is really asked are the general functions and the links between systems (for example how respiration and circulation talk to each other), not the list of muscles or bones.
8. Evolution, classification and ecology
Natural selection, speciation, the main criteria of classification, the basics of an ecosystem. It is the block that yields the least per hour of study invested, simply because it is broader and less defined than the others: keep it for last and treat it as a surface-level review, not as territory to conquer in depth.
The twelve-week plan
The criterion is not “how many topics a day”, it is what is needed for what. The cell and biomolecules are the vocabulary of everything else: without them, metabolism and molecular genetics get studied twice, the first time without really understanding.
Weeks 1-3. Cell, biomolecules, metabolism and energy. It is the hard core of the syllabus and deserves the highest investment of time: if the energy balance and membrane transport are solid here, everything else flows faster.
Weeks 4-6. Cell division and classical genetics. Plenty of exercises, few days of theory alone: these are the two blocks where a Punnett square done well is worth more than a chapter reread.
Weeks 7-9. Molecular genetics. It is the block that most resembles chemistry, as a type of reasoning: mechanisms with a precise internal logic, not lists. It is worth arriving at it with classical genetics already digested, because mutations and gene regulation rest on the same concepts of allele and phenotype.
Weeks 10-11. Anatomy and physiology in outline, evolution and ecology. Broader and less dense blocks: here the realistic goal is coverage, not depth.
Week 12. Only timed practice tests, one every two or three days, with review of the mistakes instead of new topics.
On the second sitting, 11 January: the strategy changes only if you aim at both with the same weight. If 10 December is the real goal, January should be kept as a safety net — whoever postpones arrives in January with a month less of study behind them, not a month more.
Two exercises like the real ones
(a) Genetics: a cross with ABO blood groups
A mother of blood group A, heterozygous genotype , and a father of group B, heterozygous genotype , have a child. Which blood groups are possible, and in what proportion?
The mother’s gametes are and , each with probability 1/2. The father’s gametes are and , each with probability 1/2. The Punnett square crosses the four combinations:
| (1/2) | (1/2) | |
|---|---|---|
| (1/2) | ||
| (1/2) |
The four boxes all have probability 1/4:
- : group AB (the two alleles are codominant, both are expressed) — 1/4;
- : group A — 1/4;
- : group B — 1/4;
- : group O — 1/4.
The point the question wants to test is codominance: from two parents A and B a child AB can be born, which surprises whoever has in mind only dominant/recessive as in Mendel’s peas. And a child O can be born too, because both parents carry the allele in heterozygosity — a detail that disappears if you do not write the full genotype and stop at the phenotype.
(b) Metabolism: the energy balance of cellular respiration
How many moles of ATP are obtained in total from the complete aerobic oxidation of 2 moles of glucose?
You proceed one glucose at a time and then multiply. Glycolysis produces, in the cytoplasm, 2 net ATP (by substrate-level phosphorylation) and 2 NADH. The oxidative decarboxylation of pyruvate, in the mitochondrial matrix, produces 2 NADH (one for each of the two pyruvates). The Krebs cycle, which turns twice for each glucose, produces 2 ATP (or GTP), 6 NADH and 2 FADH₂.
Adding up the reduced coenzymes for one glucose: NADH and 2 FADH₂. In the electron transport chain, with the currently accepted yields, each NADH yields about 2.5 ATP and each FADH₂ about 1.5 ATP:
To these are added the 4 ATP produced directly by substrate-level phosphorylation (2 from glycolysis, 2 from the Krebs cycle):
For 2 moles of glucose, the total is ATP. Whoever forgets to include the 2 ATP produced directly by the Krebs cycle (counting only the reduced coenzymes) arrives at a balance of 28 per glucose, underestimating every calculation by a fixed amount that then propagates into any derived question.
The mistakes that cost points
- Confusing mitosis and meiosis on the number of daughter cells. Mitosis produces two cells identical to the mother; meiosis four gametes with half the chromosome complement. A question asking “how many haploid cells are obtained from one cell undergoing meiosis” has the answer 4, not 2 — and the reverse for mitosis.
- Swapping transcription and translation. Transcription copies DNA into RNA, in the nucleus; translation reads the RNA and builds the protein, on the ribosome. They are different processes, in different compartments, with different machinery (RNA polymerase versus ribosome and tRNA): confusing them in a fill-in question loses a point that only required attention.
- Misreading “which of the following statements is NOT correct”. In the 21 multiple-choice questions the negation is the most common trap: you reach the third alternative, clearly true, convince yourself and select it, forgetting that the question was looking for the false one.
- Mishandling the 10 fill-in questions. They have no alternatives to choose from: either you know the exact number or term, or you lose the point entirely. It is worth, in the last weeks, training yourself to write the answer before seeing the options — it is a different training from multiple choice.
How we work in lessons
With those preparing Biology for the filter semester I start from where the risk of losing points is highest in proportion to the time spent: almost always classical genetics and cell division, because they are short blocks where every hour of targeted exercises is worth more than elsewhere. The lessons are mostly exercises commented on while the student solves them, not lectures: that is how systematic mistakes come out — a Punnett square set up wrongly, a negation read in a hurry, an ATP balance with a piece missing.
If you want to measure your pace against the clock, the practice test with the TOLC-MED structure covers chemistry, biology and physics in the same format — it is calibrated on the TOLC-MED, not on the filter semester, so the level and the style of the questions are not identical, but it is still a good way to train speed and reading of the questions. The correct answer is free; the guided solution, which explains step by step where you go wrong, unlocks with the first lesson.
Fifty minutes for 31 questions remain less than 100 seconds per question: it is the constraint that should govern every week of study, not only the last before the exam sitting. If you have tried a practice test and biology did not convince you, or if you come from a high school that treated it superficially, write to me and we will talk: one first lesson is enough to understand whether the problem is the content, the method or the time — and the overview of the subjects for admission tests completes the picture for those who want to train in a structured way on all three subjects of the filter semester.
