Medicine Filter Semester: How It Works

The filter semester is the new admissions system for Medicine, Dentistry and Veterinary Medicine introduced from the 2025/2026 academic year, replacing the entrance test. Enrolled students attend a semester with three subjects — Chemistry, Physics and Biology — and take standardised national exams (31 questions per subject, 45 minutes each, scoring +1/0/-0.10). A national ranking with 9 sections determines admission to the second semester. In the first cycle, over 54,000 students enrolled for approximately 17,000 Medicine places.

In this guide:

• What the filter semester is and why it was introduced
• The three subjects and exam structure
• Scoring, threshold and penalty management
• The 9-section ranking
• First cycle 2025/2026 numbers
• What happens if you don't pass all exams
• What will change in 2026/2027
• How to prepare effectively
• FAQ

What the filter semester is and why it was introduced

The filter semester replaces the old entrance test from 2025/2026 with a freely accessible university semester (cost 250 euros, maximum 3 attempts in a lifetime). Students attend three subjects (Chemistry, Physics, Biology) and sit standardised national exams — the same questions across all of Italy, on the same day. A national ranking with 9 sections determines who continues.

From 2025/2026, those wanting to enter Medicine, Dentistry or Veterinary Medicine no longer take a multiple-choice entrance test. The old restricted-entry system with a single quiz has been replaced by a freely accessible university semester — the so-called "filter semester" (or "open semester") — at the end of which a selection based on real exams determines who continues.

The reform was introduced by Law 26/2025 (14 March 2025) and made operational by Legislative Decree 71/2025 and Ministerial Decree 418/2025, according to the ministerial regulations on restricted access to Medicine. The stated objective: to overcome the shortcomings of the traditional entrance test — appeals, disputes, perception of randomness — and replace it with an evaluation based on months of actual university study.

The mechanism works as follows:

The student enrols in the open semester through the Universitaly portal, also choosing a related course as a safety net (Biotechnology, Biological Sciences, Pharmacy and others). From 1 September to 30 November they attend three courses common to all universities: Chemistry and introductory biochemistry, Physics and Biology (6 CFU each, 18 CFU total). At the end, they sit standardised national exams — the same questions, on the same day, across all of Italy. The results feed into a national ranking that determines who gains access to the second semester of their chosen course.

Important detail: the cost of enrolling in the filter semester is a flat fee of 250 euros. Enrolment is possible for a maximum of three times in one's lifetime, even in non-consecutive academic years. Those also considering a supplementary tutoring path can check the Up to Ten tutoring costs, transparent and with no contractual obligations.

The three subjects and exam structure

Each exam features 31 questions (15 multiple-choice + 16 fill-in-the-blank) in 45 minutes, in a fixed order: Chemistry, then Physics, then Biology, with 15-minute breaks between exams. Two national sittings per academic year. The threshold is 18/30 per subject, with no compensation. Students who pass an exam at the first sitting can reject the grade and retry at the second to improve.

The filter semester exams are the same at all locations and take place simultaneously nationwide. The questions are prepared by a committee of university professors appointed by the Ministry, not by individual universities.

Each sitting includes three exams in sequence in a set order:

1. Chemistry and introductory biochemistry — first exam
2. Physics — second exam (15-minute break)
3. Biology — third exam (15-minute break)

Each exam consists of 31 questions: 15 multiple-choice with 5 options and 16 completion questions (short open answers). The time available is 45 minutes per subject. It is not possible to return to a previous exam or skip one.

Two national sittings are scheduled per academic year. In the first cycle 2025/2026, the dates were 20 November and 10 December 2025. Students who pass an exam at the first sitting can reject the grade (within 48 hours of the result publication) and retry at the second sitting to improve.

The official syllabi (DM 418/2025) define 7 teaching units per subject with high school-level prerequisites in mathematics, physics, chemistry and biology. The programmes are extensive — equivalent to a genuine first-year university exam — and require both theoretical knowledge and the ability to apply it in exercises and problems.

For subject-by-subject strategies: Chemistry, Physics and Biology Preparation for the Filter Semester

An aspect many underestimate: even those who decide to sit only one or two exams must remain in the room until the entire sitting concludes. You cannot leave between exams, and electronic devices — including smartwatches — are prohibited.

Scoring, threshold and penalty management

Scoring assigns +1 for correct answers, 0 for omitted, -0.10 for incorrect (reduced from the initial -0.25 by DM 557/2025). The minimum threshold is 18/30 per subject, with no compensation between subjects. With this low penalty, random guessing among 5 options has a positive expected value (+0.12) — but this applies only to multiple-choice questions, not the 16 fill-in-the-blank.

The scoring system is the strategic heart of the filter semester, and it underwent a significant modification before the exams.

DM 418/2025 initially provided for a penalty of -0.25 points for each incorrect answer. On 4 August 2025, with DM 557/2025, Minister Bernini signed the reduction to -0.10 points. The definitive system:

• +1 point for each correct answer
• 0 points for each omitted answer
• -0.10 points for each incorrect answer

Grading is in thirtieths. The minimum threshold to pass each exam is 18/30, with no possibility of compensation between subjects — you cannot offset a 15 in Physics with a 24 in Biology. Honours (lode) are available (equivalent to +1 on the raw score).

Rounding works as follows: the grade is rounded to the nearest integer only if the 18/30 threshold is reached. Below 18, the raw score remains unchanged and the exam is not passed. Examples from the University of Foggia regulations: 17.8 stays 17.8 (not passed); 18.3 becomes 18; 18.5 becomes 19; 19.5 becomes 20.

Strategic implication of the -0.10 penalty: with such a low cost for errors, the break-even point for answering is low. If you can eliminate even one option out of five on a multiple-choice question, answering has a positive expected value. Omitting is truly worthwhile only when you're in complete uncertainty and cannot eliminate any option. The precise calculation: on a 5-option question, random guessing has an expected value of +1 x 0.20 + (-0.10) x 0.80 = +0.12. Even random guessing is statistically advantageous with this penalty — but note: this applies to the 15 multiple-choice questions, not the 16 completion questions where random answering is much riskier.

The 9-section ranking

The national ranking uses a 9-section system with decreasing bonuses: first section (700-point bonus) for those passing all three exams without rejections, down to ninth section for those who rejected their only passed exam. The final score is: section bonus + sum of grades from passed exams. Even those passing only 1 or 2 exams enter the ranking, with the option to make up missing CFU.

The ranking system was defined by DM 1115/2025, signed on 22 December 2025 — the night before the second sitting results were published. This decree radically changed the rules compared to the original framework, introducing a 9-section structure that allows access even for those who haven't passed all three exams.

How the sections work

Each student's final score consists of a section bonus + the sum of grades from passed exams (18/30 or above). Failing grades do not contribute to the score. Position within the section is the first sorting criterion; with equal section placement, the total score counts.

What does "rejected grade then recovered" mean? A student who had obtained 18 or above at the first sitting, rejected the grade hoping to improve at the second sitting, but at the second sitting scored below 18, can "restore" the original first-sitting grade. This possibility was introduced by DM 1115/2025 and was one of the most debated innovations, given that it changed the rules when the cycle was nearly complete.

The numbers to understand the thresholds

A concrete example: a student in the first section with grades of 24, 22 and 20 has a score of 700 + 66 = 766. A student in the second section with the same grades has 600 + 66 = 666. The difference between sections is enormous — 100 bonus points separate those who had a "clean" path from those who had to recover a grade. Within the same section, every exam point counts.

The theoretical maximum score is 700 + 93 = 793 (three 30-and-honours without rejections). In reality, scores in the 740-770 range (first section with grades of 20-24 per subject) were competitive for the most sought-after locations in the first cycle.

Wait-list movements and enrolment

The 2025/2026 ranking was published on 8 January 2026 on Universitaly. The main deadlines:

• 8-14 January: enrolment for students assigned in the first round
• 16-19 January: preference modification for those who didn't get a seat
• 21 January: first wait-list movement (the main one — approximately 707 remaining Medicine places, equal to 4.2% of the total)
• 24 January: enrolment deadline after wait-list movement
• 28 January: related courses ranking
• 6 March: final deadline for enrolment in other degree programmes

A significant datum: the rate of declining an assigned seat was 4-5%, consistent with historical data from the old system. For Dentistry, available places actually exceeded eligible students, with 63 places left vacant.

First cycle 2025/2026 numbers

Of 54,313 enrolled students, only 25,450 obtained at least one passing grade. Physics was the most selective subject: approximately 11,000 passed (compared to over 24,000 in Chemistry), with first-sitting pass rates between 9% and 17%. Only 10-15% of students passed all three exams on the first sitting. 90% of students in the ranking stumbled on one subject — almost always Physics.

2025/2026 was the first year of filter semester implementation. The results revealed a harder picture than expected.

Enrolled and eligible students

• 54,313 students enrolled in the open semester
• 25,450 obtained at least one 18 in at least one subject (across both sittings)
• 22,688 eligible students for Medicine and Surgery (at least one exam passed)
• 17,278 available places for Medicine and Surgery (public universities, Italian-language courses)
• 24,026 total places including Dentistry, Veterinary Medicine, English-language courses and private universities

The gap: approximately 5,400 more eligible students than Medicine places. But the most significant figure is the pass rate: less than half of initial enrolees obtained at least one passing grade.

Results by subject — Physics is the stumbling block

Results by subject (cumulative across first and second sittings) show clear differences:

• Chemistry: over 24,000 passed — the most accessible subject
• Biology: over 21,000 passed — good results at the first sitting, decline at the second
• Physics: approximately 11,000 passed — less than half compared to Chemistry

Physics confirmed itself as the true bottleneck of the filter semester. At the first sitting, the pass rate in Physics ranged between 9% and 17% depending on the university. Even at the second sitting, with more prepared and motivated students, results remained limited.

The overall figure: at the first sitting, only 10-15% of students passed all three exams. 90% of students in the ranking passed at least 2 out of 3 exams — confirming that most stumbled on one subject, almost always Physics.

Second sitting: 117,000 papers

At the second sitting (10 December), students submitted approximately 117,000 papers: 44,000 in Physics, 38,000 in Chemistry, 35,000 in Biology. The highest number for Physics reflects the high percentage of students who hadn't passed it at the first attempt.

Why were results so low?

Several factors contributed:

The vast programme in compressed timeframes — a semester that in practice lasted about two months of actual lectures, with programmes equivalent to complete university exams. Many students reported a gap between the instruction provided and the level of the exams.

The expanded applicant pool — with free enrolment, students who wouldn't have attempted the old test also participated, increasing the denominator without proportionally increasing the number of prepared candidates.

The weight of Physics — in the old entrance test, Physics had limited weight (about 4 questions out of 60). In the filter semester, it counts for exactly one-third of the selection. For students from licei classici or linguistici, this is a structural challenge that often requires a summer recovery programme to bridge accumulated gaps.

The absence of official simulations — the Ministry did not publish sample exams, leaving students without clear references on format and difficulty.

What happens if you don't pass all exams

Those passing 1 or 2 exams still enter the ranking (sections 5-9) and, if admitted, make up missing CFU in the second semester. Those with no passing grades can enrol in other programmes by 6 March — no year lost. Those passing all three exams but not entering Medicine automatically access the ranking for related courses (Biotechnology, Biological Sciences, Pharmacy). Reattempts are possible up to 3 times in a lifetime.

The filter semester was designed with a safety net: nobody completely loses their year.

If you passed 1 or 2 exams (sections 5-9)

You still enter the ranking, with a lower section bonus. If your score is sufficient for placement, you're assigned to a location where you'll need to make up the missing CFU during the second semester, alongside new subjects. Every university organises at least two make-up exams per subject.

If you obtained no passing grades

You don't enter the ranking, but you can enrol in any other degree programme — even beyond the ordinary university deadlines — by 6 March 2026. No year lost: the filter semester fees cover the first semester.

Related courses: the safety net

At enrolment, every student also chooses a related course. If not admitted to Medicine/Dentistry/Veterinary Medicine but having passed all three exams, they automatically enter the ranking for related courses (published 28 January 2026). Related courses include Biotechnology (L-2), Biological Sciences (L-13), Pharmacy (LM-13), Animal Sciences (L-38) and some Health Professions. The 18 CFU from the filter semester are automatically recognised.

Retrying: up to 3 times

Enrolment in the filter semester is possible for a maximum of three times in one's lifetime, even in non-consecutive years. Those who don't get in on the first attempt can retry the following year with stronger preparation.

What will change in 2026/2027

The three subjects (Chemistry, Physics, Biology) will remain the same for 2026/2027. Modifications under discussion include potentially reduced programmes, more time for preparation, and more time between course end and exams. Whether the 9-section system with rejected grade recovery will be confirmed is unclear. Those who start preparing now are building competencies valid regardless of regulatory changes.

The filter semester is guaranteed by regulation until 2026/2027. After that date, there are no certainties — the system could be confirmed, modified or replaced.

Minister Bernini has ruled out a return to the old entrance test, but has acknowledged that the first cycle revealed shortcomings. The modifications under discussion for next year:

Reduced programmes — the syllabi could be lightened, given that the programme's vastness was identified as the main cause of mass failures.

More time for preparation — lectures could start earlier or last longer, overcoming the "effective two-month" period of the first cycle.

More time between end of courses and exams — in 2025/2026, the gap between the last lecture and the first sitting was judged insufficient.

Ranking: it is unclear whether the 9-section system with recovery of rejected grades will be confirmed or whether it was a transitional measure for the first year.

Meanwhile, appeals to the TAR (administrative court) are underway. Several law firms are challenging the legitimacy of rules changed during the cycle (DM 1115/2025 published the night before the results) and disparities between universities in teaching management.

For those preparing for 2026/2027: the three subjects (Chemistry, Physics, Biology) will remain the same. Any changes will concern the semester duration, programme difficulty or ranking rules — not the disciplines. Those who start preparing now on these three subjects are building competencies that will be valid regardless of regulatory changes.

How to prepare effectively

School-level preparation is not enough: Physics was passed by only 9-17% on the first sitting. You need to start with a diagnosis to identify gaps, study for the exam format (31 questions in 45 minutes, less than 90 seconds per question), and treat Physics as the subject that determines whether you get in or not. Those starting with Physics gaps from a non-scientific high school need months of work, not weeks.

First-cycle results made one fact evident: school-level preparation is not enough. Physics was passed by only 9-17% of students at the first sitting, and even Chemistry and Biology required a level above high school knowledge.

Start with diagnosis

Before studying, you need to understand where you stand. A serious self-assessment on each of the three subjects — not "I know Biology because I like it", but "I can solve thermodynamics exercises in 3 minutes" — allows you to allocate time intelligently.

Those coming from a liceo scientifico start with an advantage in Physics and Chemistry; those from a classico or linguistico have a structural gap in Physics that requires months of work, not weeks. Identifying gaps immediately is the difference between preparing and deceiving yourself that you're preparing.

Study for the exam, not for the programme

The syllabi are vast — 7 teaching units per subject with dozens of sub-topics. But the exams have a specific format: 15 multiple-choice questions and 16 completion questions, in 45 minutes. That means less than 90 seconds per question, with a mix of theory and application.

Effective preparation is not rereading the book: it's practising with exam-style questions, under time pressure, with the penalty active. Every study session should alternate targeted theory (understanding the concept) and timed practice (applying it within the time limit).

The Physics problem

Physics was the most selective exam in the first cycle for a precise reason: it requires the ability to formalise problems and perform calculations, not just recognise concepts. Completion questions in Physics often ask for a numerical result — and there's no way to get there without having done dozens of similar exercises.

The strategy: don't treat Physics as "one of the three subjects", but as the subject that determines whether you get in or not. For those starting from a weak foundation, an individual tutoring path in Physics — with a tutor who knows the exam format and knows where points are lost — can make a concrete difference.

For specific strategies on each subject: Chemistry, Physics and Biology Preparation for the Filter Semester

Realistic simulations

In the first cycle, the Ministry did not provide official sample exams. Many students went to the exam having never simulated 45 minutes with 31 questions in the correct format. Don't repeat this mistake.

Look for simulations that follow the ministerial format: 15 multiple-choice + 16 completion, 45 minutes, -0.10 penalty. Do them under exam conditions — no breaks, no notes, with an active timer. The goal is not "finishing" but managing the balance between accuracy and speed: it's better to answer 25 questions well and leave 6 blank than to answer all of them with 10 errors.

Strategic management of the two sittings

Having two sittings is an enormous advantage if you use it wisely. The strategy depends on your starting level:

If you're prepared in all three subjects, the first sitting is your main opportunity. Aim to pass everything on the first attempt and use the second only for potential improvement.

If you have a weak subject (typically Physics), consider concentrating study on that subject for the second sitting. But beware: rejecting a first-sitting grade to improve is a risk. If at the second sitting you don't reach 18, you must hope to "recover" the rejected grade — and this possibility, introduced in 2025/2026, may not be confirmed for subsequent cycles.

Why individual tutoring works for the filter semester

The filter semester creates a particular situation: thousands of students attend the same university lectures, but start from very different levels. Those from a liceo scientifico have solid foundations; those from a linguistico or professional institute have gaps in Physics and Chemistry that university lectures aren't designed to fill.

A tutor who knows the exam format, identifies specific gaps and builds a targeted path is the investment with the highest return. Not to "review everything", but to fill the gaps that the university course doesn't have time to fill — and to train the specific format of 31 questions in 45 minutes with a penalty.

At Up to Ten we work on exactly this. Our Chemistry, Physics and Biology tutors know the filter semester syllabi and prepare individual paths calibrated to each student's starting level. Every lesson is tracked in the Up to Connect platform — topics covered, exercises assigned, simulation results — and parents see everything in real time.

Chemistry Tutoring · Physics Tutoring · Biology Tutoring

FAQ

What is the Medicine filter semester? It is the new admissions system for Medicine, Dentistry and Veterinary Medicine introduced from 2025/2026. It replaces the old entrance test with a freely accessible university semester during which students take courses in Chemistry, Physics and Biology. At the end, standardised national exams determine who continues through a national ranking.

How many questions are there in each filter semester exam? Each exam has 31 questions: 15 multiple-choice with 5 options and 16 completion (short open answers). The time is 45 minutes per subject, with 15 minutes of break between exams.

What is the minimum score to pass the exams? A minimum of 18/30 in each of the three subjects is required. Compensation between subjects is not possible: a 15 in Physics is not offset by a 25 in Biology. The penalty for an incorrect answer is -0.10 points (reduced from the original -0.25 by DM 557/2025).

How many times can I enrol in the filter semester? Up to three times in your lifetime, even in non-consecutive academic years.

What happens if I don't pass all three exams? You can still enter the ranking if you've passed at least one exam — DM 1115/2025 introduced a 9-section system that includes those with 1 or 2 exams passed, with the possibility of making up missing CFU at the assigned location. Those who obtain no passing grades can enrol in other degree programmes by 6 March of the following year.

Does the filter semester apply to private universities? No. Private universities (San Raffaele, Cattolica, Campus Bio-Medico, Humanitas, LUM and others) maintain their own admission tests, separate from the filter semester. They represent an alternative for those who don't pass the national selection.

Is Physics really the hardest exam? First-cycle data confirms it: only approximately 11,000 students passed Physics (across both sittings), compared to over 24,000 in Chemistry and over 21,000 in Biology. First-sitting pass rates ranged between 9% and 17% depending on the university. Physics requires calculation and formalisation abilities that the other two subjects require less.

When do the 2026/2027 filter semester exams take place? The exact dates have not yet been published. In the first cycle (2025/2026), the first sitting was held on 20 November and the second on 10 December. Dates for 2026/2027 will be defined by a ministerial decree during 2026.

How does the ranking work? The national ranking is divided into 9 sections ordered by merit. The first section (700-point bonus) includes those who passed all three exams without rejections. Subsequent sections have decreasing bonuses. The final score is: section bonus + sum of grades from passed exams (only those 18 or above). Students are assigned to locations based on expressed preferences and ranking position.

Is it worth starting to prepare now for 2026/2027? Yes. The three subjects — Chemistry, Physics and Biology — are certain, regardless of possible changes to programmes and regulations. Those who start studying months in advance, especially in Physics, arrive at the semester with solid foundations and can focus on refinement rather than starting from zero with the university course.