The IMAT (International Medical Admissions Test) is the entrance test for the degree courses in Medicine and Surgery taught in English offered by several Italian universities — Pavia, Milano Statale, Bologna, Padova, Roma La Sapienza, Torino, Napoli, Bari, Messina, Parma and others. It is a test in English, open to both Italian and international students, and every year it attracts thousands of candidates for very few places.
I have been preparing students for the IMAT for a few years, and what strikes me most is how many arrive underestimating it because “it’s like the Italian test but in English”. It isn’t. The language changes, the style of the questions changes, and the way you should distribute your energy changes. In this post I set down what I see really working: how the test is built, where it is worth investing time, the mistakes that keep recurring, and a plan for anyone starting now.
What the IMAT is and who should take it
The IMAT gives access to degree courses in Medicine and Surgery taught entirely in English. It is a different route from the TOLC-MED (which is in Italian and covers the courses taught in Italian): if your goal is to study medicine in an international environment, or if you have a solid grounding in English and want to keep this option open, the IMAT is the way in.
Two things to clear up straight away, because they cause confusion:
- It is not “easier” than the Italian test. The admission thresholds in the most sought-after courses are very high and the competition is international. The fact that places are reserved for non-EU students does not lower the bar for those competing for the EU places.
- The structure of the test has been revised in recent years. Content, number of questions and scoring criteria have changed several times. That is why the first thing I always say is: read the official CINECA call for the year in which you are sitting and take the exact numbers from there (how many questions, how much time, how many points per correct answer and how many you lose for a wrong one). Don’t trust guides that are two years old — this one included, if you read it in a different year.
That said, the areas of knowledge that the IMAT assesses are stable in substance, and that is what we build the preparation on.
The areas of the test (and how to tackle them)
The IMAT is divided into a few main areas. The exact split of the questions changes over the years, but the scientific core — biology, chemistry, physics and maths — is what decides your score. In recent years the weight of the science subjects has increased relative to the reasoning and general knowledge part: good news for those with a solid base from the science high school, less good for those counting on “getting by with logic”.
Logical reasoning and general knowledge
Logic questions (sequences, syllogisms, comprehension of argumentative passages) and a few general knowledge questions. It is the part most “trainable” in the short term: logic improves enormously with repeated practice, because you learn to recognise the patterns of question. General knowledge, on the other hand, cannot be built in two weeks — if it carries little weight in that year’s call, I wouldn’t throw too much time at it.
The practical advice: do lots of timed logic questions right from the start, so that you arrive at the test with the automatic responses already well worn.
Biology
For most candidates this is the section that makes the difference. The IMAT biology is detailed: cell and molecular biology, genetics, metabolism, basic physiology, structure and function of biomolecules. It is not enough to have “understood” — you need to know the details, because questions often turn on fine distinctions (mitosis vs meiosis, transcription vs translation, the steps of a metabolic pathway).
Here the work is one of volume and precision: cover the whole programme and then revise it until the details become automatic. On sciences this is exactly the kind of work we do — cell and molecular biology explained so that the concepts hold up under pressure, not just the day before.
Chemistry
General and inorganic chemistry: atomic structure, chemical bonding, stoichiometry, equilibria, acids and bases, redox reactions. This is a section where you recover well with method, because it is made of rules that can be applied systematically. Those who get chemistry wrong usually don’t have a gap in theory: they have a gap in practice on problems. Stoichiometry in particular is a machine that, once set up, always works the same way — but it has to be oiled with dozens of exercises.
A note on language: many chemical terms in English are transparent for an Italian speaker, but watch out for false friends and units of measurement. It is worth practising directly on questions in English, not translating in your head.
Physics and maths
The quantitative part. Physics: mechanics, thermodynamics, basic electromagnetism, optics — the classic high school programme, but with problems that have to be solved quickly. Maths: functions, equations, analytic geometry, elementary probability, a little calculus. It is not advanced maths, but it is maths you must be able to apply without hesitating, because the time per question is short.
My advice: don’t neglect physics and maths thinking “there are only a few questions anyway”. In a test where points are decided on a knife-edge, every question you bring home with certainty is one you haven’t left to chance.
The mistakes I see repeated
Working with IMAT students, the same problems come back on schedule. If you know them in advance, you avoid at least half.
- Studying in Italian and testing yourself in English at the last minute. It sounds like a detail, but reading a genetics question in English against the clock is different from having studied it in Italian. Those who train on questions in English from the start arrive at the test without the mental cost of translation.
- Underestimating detailed biology. “I studied it in high school” is not enough: the IMAT asks for a finer level. You need serious, repeated revision, not a re-read.
- Not managing time. It is the mistake that costs the most points of all. Many candidates get stuck on 2-3 hard questions and reach the end of the test with easy questions left blank for lack of time. Golden rule: if a question resists beyond the average time, you flag it and move on. You come back later.
- Ignoring the penalty criterion. The IMAT (in almost all its versions) takes off points for wrong answers. This changes the strategy: guessing at random doesn’t pay, but if you can eliminate a couple of options the reasoned choice often becomes advantageous. Understanding the mathematics of the scoring for your year — from the call — is part of the preparation, not a detail.
- Starting too late. You can’t prepare for the IMAT in a month if you start from zero. Biology above all needs time to settle.
A realistic study plan
There is no perfect plan that is the same for everyone, but this is the structure I propose to those starting with a few months ahead. Adapt it to the time you have.
Phase 1 — Diagnosis and basics (weeks 1-4). First of all a cold mock exam on official questions from past years, to see where you stand. From there you start covering the theory of the weakest areas, with priority to biology (it is the one that needs the most time to be absorbed). In parallel, a bit of logic every day to wear in the automatic responses.
Phase 2 — Building up (weeks 5-10). Complete coverage of the chemistry, physics and maths programme, with targeted exercises for each topic. Biology continues in revision. This is the phase in which the bulk of the preparation accumulates.
Phase 3 — Mock exams and polishing (last 4-6 weeks). Complete, timed mock exams in English, at regular intervals. Each mock exam has to be analysed: the score doesn’t matter, what matters is understanding why you got each single question wrong. This is the phase in which you gain the points that make the difference between “close to the threshold” and “in”.
You will find the right rhythm yourself, but one principle always holds: a little every day is better than a lot on one day. Biology and chemistry are built by layering, not by brute force.
How we work in lessons
When I prepare a student for the IMAT, the first lesson is almost always a diagnosis: we look together at a mock exam taken cold and find where the real gaps are, which are often not the ones the student imagines. From there we build a tailor-made plan, subject by subject, with exercises in English from the start.
The value of one-to-one lessons here is that you don’t waste time on what you already know: we go straight to the weak points. And the mock-exam part — with error analysis one by one — is where I see students make the leap. The results speak: among those I follow, 97% pass the test they are preparing for, with a method that focuses on understanding, not on parrot-fashion memorisation.
If you want to understand where you stand and how much work you need, the best way is to start with a free introductory call: a chat in which we look together at your starting level and I tell you honestly what is needed. If instead you are still choosing between the IMAT, the TOLC-MED and other routes, take a look at the overview of admission tests to get your bearings, or go straight to the IMAT preparation page for programme and packages.
The biology of the IMAT is the one in Cell and molecular biology for the medicine test; if you are keeping the Italian route open as well, the guide to the medicine “filter semester” explains how the test changes, and chemistry calculation errors are collected in Stoichiometry: the typical mistakes.
The IMAT is a hard but predictable test: those who prepare for it with method, in good time and in English from day one arrive at the test with their cards in order. The rest is keeping your nerve on the day — and you only get there with the mock exams behind you.
Would you like to take that first cold mock exam I mentioned above, free and right away? Try the free IMAT mock exam (the questions are in English): same structure, same scoring and same questions in English as the real test, with immediate marking and a breakdown by topic — so you know today where to start.
