Medicine filter semester 2026/27 (ex TOLC-MED): guide

September 2026 update: the TOLC-MED is no longer the entrance test

Since 2025/26 access to Medicine and Surgery, Dentistry and Veterinary Medicine no longer goes through a scored test like the TOLC-MED: you get in through the filter semester. Open enrolment (within the limits of the places) on Universitaly (the national university portal), attendance of three courses worth 6 ECTS credits each — Chemistry and biochemistry fundamentals, Physics, Biology — with two sittings per subject and a national merit ranking based on the scores obtained.

If your goal is a healthcare professions degree (nursing, physiotherapy, midwifery), the test is a different one: 60 questions in 100 minutes with scoring +1.5/−0.4. The guide is How to prepare for the healthcare professions test, and here is the dedicated preparation.

For 2026/27 the sittings are 10 December 2026 and 11 January 2027, at 11:00. Each exam lasts 50 minutes and is made up of 31 questions per subject (21 multiple-choice with five options + 10 fill-in) — no logic, general knowledge or English. Scoring under the decree: +1 for a correct answer, 0 for a skipped one, −0.1 for a wrong one (art. 8 DM 941/2026), so a much lighter penalty than the −0.25 of the old TOLC-MED. The mechanism comes from Law no. 26 of 14 March 2025 and Legislative Decree 71/2025 (structure and dates set by DM MUR 941/2026 and DD 249/2026); the 2026/27 places are 30,225 in total, of which 27,001 in Medicine (DM 1004/2026).

The TOLC-MED was not withdrawn by CISIA by choice: it was replaced by the legislative reform. It was used for only one season, in 2023 for the 2023/24 academic year. What remains valid in this post: the subjects are largely the same — chemistry, physics and biology — so everything on the content to study, the typical mistakes and the preparation method below is still useful. What is no longer valid is everything concerning the old free-scoring format and the sessions that could be repeated several times a year: read this section as a historical reference, not as a description of the current test.

What the TOLC-MED was and how it was built

The TOLC-MED was run by the CISIA consortium (the body that organises the TOLC tests for Italian universities), was taken online with on-site or remote supervision depending on the session, and lasted 1 hour 30 minutes. It was made up of 50 multiple-choice questions divided into four sections, each with its own maximum time (structure from the official CISIA guide to the TOLC-MED):

• Text comprehension and knowledge acquired in your studies — 7 questions, 15 minutes
• Biology — 15 questions, 25 minutes
• Chemistry and physics — 15 questions, 25 minutes (single section)
• Maths and reasoning — 13 questions, 25 minutes

Scoring: +1 for a correct answer, −0.25 for a wrong answer, 0 if you don’t answer. The maximum gross score was 50.

The TOLC-MED could be taken several times a year in the sessions opened by CISIA (typically April, July, November and other intermediate ones), and the best score obtained within the deadlines of the ministerial call counted — a possibility that the filter semester does not replicate: in 2026/27 there are only the two sittings per subject of 10 December 2026 and 11 January 2027.

The sections that weigh (and how to tackle them)

On paper every question is worth the same, but in practice the sections behave very differently. Let’s see what to expect.

Text comprehension and knowledge (7 questions, 15 minutes)

A section that many underestimate and then pay the price for. These are short passages followed by comprehension questions (main idea, inferences, the meaning of a term in context) and “general knowledge” questions in a scientific-institutional sense (structure of the healthcare system, ethical principles of the profession, basics of argumentative logic).

15 minutes for 7 questions means more than 2 minutes each — it is the section with the most relaxed timing. The trap is reading the passages distractedly because “there’s biology afterwards anyway”. It doesn’t work like that: 1-2 mistakes here weigh as much as in chemistry, and the passages need real concentration.

Strategy: read the passage once at normal speed, then the questions, then go back to the passage for the precise points you need. Don’t answer “from memory” after a single read.

Biology (15 questions, 25 minutes)

The weightiest section and the one in which those who studied seriously at a science high school start with an advantage. Recurring topics:

• Chemistry of life: biological macromolecules (carbohydrates, lipids, proteins, nucleic acids), bonds, structure of the plasma membrane.
• Cell: prokaryotic vs eukaryotic, organelles and their function, cytoskeleton, cell cycle.
• Mitosis and meiosis: phases, key differences, consequences of errors (non-disjunction, syndromes).
• Genetics: Mendel’s laws, family trees, the most frequent genetic diseases (sickle-cell anaemia, cystic fibrosis, colour blindness, haemophilia), basics of blood-group genetics.
• DNA and protein synthesis: structure of DNA, replication, transcription, translation, genetic code, mutations.
• Bioenergetics: cellular respiration (glycolysis, Krebs cycle, transport chain), fermentation, photosynthesis at a conceptual level.
• Systems of the human body: cardiovascular, respiratory, digestive, excretory, nervous and endocrine. “High school textbook” level — they don’t ask for the detail of innervation, but the general function yes.
• Basic immunology: innate and adaptive immunity, role of B and T lymphocytes, antibodies.
• Reproduction and development: gametogenesis, fertilisation, early embryonic stages in broad terms.

25 minutes for 15 questions are 100 seconds per question: decent time, but not infinite. If you get stuck for 4 minutes on an anatomy question you can’t remember, you lose precious time. Better to flag it and come back to it later.

Chemistry (in the Chemistry and physics section: 15 questions, 25 minutes)

The section that separates those who score 35 from those who score 45. Topics:

• Atom and periodic table: electron configuration, trends in periodic properties (atomic radius, ionisation energy, electronegativity, electron affinity).
• Chemical bonding: ionic, covalent (polar and non-polar), hydrogen, metallic; basic molecular geometry (VSEPR), polarity of molecules.
• Inorganic nomenclature: oxides, anhydrides, hydracids, oxyacids, salts. Free questions if you study them, lost if you snub them.
• Stoichiometry: moles, molecular formula, limiting reagent, percentage yield. If you are weak here, start from my post on typical stoichiometry mistakes — I see the same mistakes repeated across dozens of students.
• Solutions: concentration (molarity, molality, percentage by mass and volume), dilutions, colligative properties at a basic level.
• Acids and bases: Arrhenius, Brønsted, Lewis definitions; calculating the pH of strong acids/bases and a qualitative introduction to weak ones, indicators.
• Chemical equilibrium: Le Chatelier’s principle, equilibrium constant in conceptual form.
• Redox reactions: oxidation number, balancing simple redox, basic electrochemical cells.
• Chemical kinetics: reaction rate, factors that influence it, catalysts at a qualitative level.
• Organic chemistry: functional groups (alcohols, aldehydes, ketones, carboxylic acids, amines, esters, amides), basic IUPAC nomenclature, isomerism (chain, position, geometric, optical at an introductory level), reactivity of the main groups in broad terms.

The chemistry of the TOLC-MED is broader than deep: nobody asks you to calculate the pH of a buffer exactly, but you must tell an aldehyde from a ketone at a glance and know which functional groups do what.

Maths and reasoning (13 questions, 25 minutes)

Maths and reasoning programme:

• Algebra: first- and second-degree equations and inequalities, with absolute values and basic irrational ones, systems.
• Elementary functions: lines, parabolas, exponential, logarithm. Domain, sign, intersections, reading the graph.
• Basic trigonometry: sine, cosine, tangent, special values, fundamental identity, solving right-angled triangles.
• Analytic geometry: distance between points, line through two points, equation of the circle, parabola in standard form.
• Euclidean geometry: areas and volumes of standard figures, Pythagoras’ and Euclid’s theorems, similarity.
• Probability and statistics: classical probability, independent and conditional events, mean, median, mode.
• Reasoning: number series, logical deductions, problems with data and relationships.

No derivatives, no integrals, no formal limits. If you reached Year 5 of high school with a minimum of consistency, the programme is already covered. If you feel you have gaps, a structured revision can help — I wrote a post on how to tackle maths with method in Studying maths without stress.

Physics (in the Chemistry and physics section)

The section that trips up those who haven’t studied it enough at high school. Programme:

• Kinematics: uniform rectilinear motion, uniformly accelerated motion, free fall, uniform circular motion.
• Dynamics: Newton’s laws, forces (weight, friction, normal, elastic), inclined plane.
• Work and energy: kinetic, gravitational and elastic potential, work, conservation of mechanical energy.
• Fluids: pressure, Archimedes’ principle, Stevin’s law.
• Thermodynamics: temperature, heat, heat capacity, ideal gas laws, first law at a qualitative level.
• Basic electromagnetism: Coulomb’s law, simple electric field, current, Ohm’s law, series and parallel circuits.
• Waves and geometric optics: wavelength, frequency, reflection, refraction, thin lenses at a conceptual level.

The level is that of the science high school, no more. If you studied well up to Year 5 it is manageable; if you come from a classical or linguistic high school, it is the section in which to invest the most extra time. For targeted revision it can help to start from the typical physics mistakes in high school and from my in-depth look at Year 5 electromagnetism.

The most common mistakes I see

After preparing dozens of students for Medicine and Veterinary Medicine, the mistakes repeat. Knowing them in advance means avoiding them.

1. Studying only biology because “it gives the most points”. Wrong. Biology has 15 questions and chemistry and physics together another 15, but chemistry is statistically where most students lose the most points. Investing more in chemistry in the first weeks often gives the highest return.

2. Guessing on everything thinking “it’s only −0.25”. A false friend. On 10 random questions, with five options, you get on average 2 right (+2) and 8 wrong (−2): net gain zero and a lot of variance. It becomes worthwhile as soon as you confidently rule out at least one option (about +0.06 per answer; +0.17 with two ruled out). If you can’t rule out any, leave it blank.

3. Not doing timed mock exams. The TOLC-MED is a test of time management even before knowledge. Knowing the topics is not enough: you need to know how long you take to read a biology question, when to skip and when to insist. At least 6-8 full timed mock exams in the last 6-8 weeks.

4. Neglecting chemical nomenclature and basic physics formulas. They are “free” points if you have studied them, lost if you haven’t. It is the part with the best effort-to-score ratio of the whole test.

5. Waiting until the last moment to start studying. The filter semester has only two sittings per subject (10 December 2026 and 11 January 2027): unlike the old TOLC-MED, which could be retaken several times a year using the first attempt as a diagnostic, here there is no equivalent margin to “see how it goes” and recover. Better to start with a diagnostic mock exam right away, not wait for November.

6. Studying 12 hours a day in the last month. It doesn’t work like that. The brain consolidates with sleep and with spaced repetition. 4-5 hours of targeted study a day, well structured, are worth more than 10 confused hours. The last 48 hours before the test should be almost empty: light revision, sleep, hydration, stop.

7. Skipping error analysis after mock exams. Doing 10 mock exams without analysing them in depth is almost useless. After each mock exam: list of errors, category (missing theory / wrong method / carelessness / ran out of time), targeted correction. That is where the score grows, not in “doing another mock exam”.

A realistic study plan ahead of the December and January sittings

If the sittings of 10 December 2026 or 11 January 2027 are ahead of you, this is the timeline I have my students follow. Adapt the weeks according to how much time you have.

Weeks 1-2: diagnosis. One complete timed mock exam (in TOLC-MED style, the historical structure closest in content to chemistry, physics and biology). Aim: to see where you stand, not to get a good mark. Note the sections where you got most wrong and the specific topics (e.g. “stoichiometry with limiting reagent”, “Mendelian genetics with two characters”). That is your plan.

Weeks 3-12: targeted revision by theme blocks. One topic at a time, 2-3 hours of theory + 30-40 targeted exercises. Recommended order: general chemistry → stoichiometry → organic chemistry → biology (cell, genetics, protein synthesis, anatomy) → maths (algebra, functions, trigonometry, geometry) → physics (kinematics, dynamics, energy, thermodynamics, electromagnetism). Don’t move on to the next block until you have closed the current one at 75-80%.

Weeks 13-18: mock exams and polishing. One or two full mock exams a week, always timed. Detailed error analysis (it is not enough to say “I got 8 wrong in chemistry”, you need to know which types of question you get wrong). Targeted revision on the weak topics. In the last 10 days: no new topics, just consolidation and managing anxiety.

Test week: sleep. I’m not joking. Sleeping badly the night before loses you more points than an entire extra week of study. The day before: read a summary of nomenclature and formulas, do one or two easy exercises “to warm up your hand”, then stop. No mock exam the day before.

Realistic total time: 150-250 hours of targeted study if you start with decent high school foundations, 300+ hours if you come from a classical high school or have been out of study for a few years. It sounds like a lot: spread over 5-6 months it is 8-12 hours a week, sustainable.

For those who are anxious, I wrote a specific piece on how to handle test anxiety that also applies to admission tests — the mechanism is the same.

Test yourself before starting weeks of revision. For the real format there is the filter semester mock exam: three separate 50-minute tests, one per subject. For a mixed revision, the free TOLC-MED mock exam replicates the historical structure of the test — 50 questions in 90 minutes, same scoring +1/−0.25/0 — on chemistry, physics and biology, the same subjects as the filter semester. At the end it shows you the breakdown by area, so you already know where to concentrate the first weeks instead of revising everything without an order of priority.

How we work in lessons

In private lessons I always start from a diagnosis. We use the first hour to do a mini-test reasoned through together: not just to see where you go wrong, but to understand why you go wrong (is theory missing? is method missing? is reading too slow? a calculation error from carelessness? time management?). These are different causes and they are cured in different ways.

From there I build a weekly plan: typically one lesson a week for each of the three subjects of the filter semester — chemistry, physics and biology — with more weight on the one where you lose the most points, and complete mock exams reviewed together in the last weeks before the December and January sittings. The 10-hour package covers about 4-5 weeks of intensive preparation and typically you need more than one over the whole preparation.

We work online with a graphics tablet and shared screen. For mock exams I use the historical TOLC-MED format (the closest in content to the three subjects), so that you arrive with the method already worn in even though the official format of the real exam is different (separate 50-minute tests, with fill-in questions as well as multiple choice).

One thing I always say: neither the TOLC-MED nor the filter semester can be “guessed”. Those who get into Medicine with a good score are those who put in the hours, studied with the right method, and took the time to analyse every mistake. It can be done, but not in three weeks.

If you want to understand whether it makes sense to work together, I offer you a free 30-minute introductory call: you tell me where you stand, we do a few quick questions, I tell you honestly how many hours you need and where to concentrate them. No hard sell — if I see that you are managing on your own, I’ll tell you.

If instead you are aiming at a three-year healthcare degree (nursing, physiotherapy and the others), the test is the national healthcare professions one, with a different structure and scoring: the guide is Healthcare professions test: structure, programme and how to prepare.

For the full picture of the tests I prepare for there is the Admission tests page; for individual subjects see chemistry and biology, maths and physics. If you already know you want to begin, the filter semester preparation page summarises the programme, packages and how we work together. If you are aiming instead at Medicine in English, the test is a different one and has a separate guide: How to prepare for the IMAT; for the biology of the block, Cell and molecular biology for the medicine test.

Good luck. Medicine is hard, but the difference between those who get in and those who don’t is usually not talent — it is method and hours. Both things that can be built.