The filter semester for Medicine in Italy: how to prepare for the Chemistry, Physics and Biology exams

The short answer

Since 2025/26, the entrance test for Italian-language Medicine and Surgery, Dentistry and Veterinary Medicine degrees in Italy has given way to the “filter semester” (semestre filtro, also called the open semester): at Italy’s state universities anyone can enrol, take Chemistry and Introductory Biochemistry, Physics and Biology, worth 6 credits (CFU) each, and sit three national exams, the same across Italy. In 2026/27 each exam has 31 questions, 21 multiple-choice and 10 fill-in-the-blank, in 50 minutes, scored +1 for a right answer, −0.1 for a wrong one and 0 for a blank. An exam is passed with 18 out of 30; the sittings are on 10 December 2026 and 11 January 2027, and the national ranking comes out on 22 January 2027 (Ministerial Decree 941/2026 and Directorial Decree 249/2026).

To prepare, study the three subjects side by side from the first week, with the ministry’s syllabus as your checklist: after each lecture recall what you heard from memory, do Physics and Chemistry problems every day, and come back to each topic at growing gaps instead of rereading everything in December. In the last weeks, practise the real format: 31 questions in 50 minutes, on paper, with fill-in questions where you have to produce the answer yourself. Testing yourself leaves far more remembered than rereading (Roediger & Karpicke, 2006), and spreading study out more than cramming it (Cepeda et al., 2008).

What the filter semester is, and where the rules come from

The reform comes from Law no. 26 of 14 March 2025, which asked the Italian government to rework admission to Medicine and Surgery, Dentistry and Veterinary Medicine, and Legislative Decree no. 71 of 15 May 2025, which replaced the entrance test with the filter semester. The details are set each year by a decree of the Ministry of University and Research (MUR): for 2026/27 it is Ministerial Decree no. 941 of 10 July 2026, which gathered and replaced the six decrees of 2025, and the exam dates are in Directorial Decree no. 249 of 13 July 2026. The rules and figures in this guide come from those.

Enrolment is open to anyone with the qualification to enter university. For 2026/27 it ran on the Universitaly portal from 13 July to 3 August 2026, with a flat fee of €250 paid by 6 August to the university you chose, unless you qualified for an exemption; if you then enrol in Medicine, Dentistry or Veterinary Medicine, it comes off that year’s fees. Alongside the semester you enrol, free, in a “related course” (corso affine), which is where you continue if you don’t get a place: Biotechnology, Biological Sciences, Pharmacy, Animal Science and some health-profession degrees, Nursing among them. You also list at least 10 universities for the degree you want.

Teaching starts on 1 September and ends at least ten days before the first exam. Attendance is compulsory and checked by the university, and you can only sit the exams if you met it. You can enrol in the filter semester at most three times, in any years, and if you enrol again you don’t have to attend again. None of this applies to the degrees taught in English, which have an admission test of their own, and for 2026/27 not to non-state universities either.

The exams: format, scoring and the 2026/27 dates

There are three exams, one per subject, held on the same day, at the same time and with the same questions at every university. Each has 31 questions: 21 multiple-choice, with five options of which only one is right, and 10 fill-in-the-blank, where you write the missing answer in capitals, and it must express “a single, unambiguous concept”. You get 50 minutes per exam and a 30-minute break between them, and you have to stay in the room for all of them, even if you only sit one or two.

It’s on paper. You get a sealed pack with the questions and two sheets for rough work; for multiple-choice questions you mark your answer with an X, using the black pen the university gives you, and you can change an answer only once. To leave a question blank you cross out a small circle on the answer sheet, and once you have, you can’t change it.

Scoring is 1 point for each right answer, 0 for each blank and −0.1 for each wrong one. Marks are out of 30, as all Italian university exams are, with honours (lode) worth one more point, so the three exams together are worth at most 93 points. Each exam is passed with at least 18 out of 30.

In 2026/27 the first sitting of all three subjects is on Thursday 10 December 2026 and the second on Monday 11 January 2027, both from 11:00 Italian time. You must sit at least one of the two for each subject; if you sit both, the higher mark counts automatically, as long as it is at least 18. The ministry says results come out on 23 December and 20 January; after the second sitting you have until 23:59 the day after results to turn a mark down, and if you say nothing it counts as accepted.

Some things changed after the first year, 2025/26, when each exam had 15 multiple-choice and 16 fill-in questions in 45 minutes and the sittings were on 20 November and 10 December. Now the semester is longer, the exams later, each exam has 50 minutes, the break is 30 minutes, and the better of two marks counts. The rules may change again: if you start in 2027/28, check that year’s decree.

The ranking, the universities, and what happens if you don’t pass everything

The national ranking has three sections. The first holds everyone with at least 18 in all three exams, ranked on 300 points plus the sum of their marks; the second those who passed two, on 200 points plus the two marks; the third those who passed one, on 100 points plus that mark. So anyone who passed all three exams ranks above anyone who passed two, whatever the marks. On equal points, a student with a certified disability or an invalidity of 66% or more goes first, then the younger student, then the one with the higher average.

In 2026/27 the ranking comes out on Universitaly on 22 January 2027, with the university you’re assigned to, which depends on your position, the order of universities you listed, the choices of those above you and the places available. You have from 22 to 28 January to enrol; from 2 to 5 February, those without a place can choose among the universities with places left. Places are set each year, university by university, by a ministerial decree: for 2026/27, Ministerial Decree no. 1004 of 6 August 2026. Notices in your personal area on Universitaly count as official notification, so check it.

If you rank high enough but passed only one or two exams, you register at the university you’re assigned to and make up the missing credits through its own make-up exams, at least two per subject, before the second semester starts; if you don’t make them up in time, you lose the place. If your position isn’t high enough, you continue in the related course you chose when you enrolled, even above its usual numbers, normally up to 20% of each university’s places. If you move to any other degree, the university decides how much of the semester’s credits to recognise, and it may be only part.

How to study the three subjects, a step at a time

That’s three 6-credit subjects in a little over three months, examined on the same day, so you can’t prepare them one after another as you might for ordinary exams. Study them side by side and keep all three alive until January. The syllabus the ministry published on 19 June 2026 splits each subject into seven units, each with its weight in credits: use it as the list of what can come up and as a guide to how much time each part deserves. In Biology, for example, cell structures are worth 1.75 of the 6 credits; in Physics, mechanics is worth 1.4, and fluid mechanics and electricity and magnetism 1.2 each. The syllabus and the exams are in Italian, so learn the Italian terms as you go.

The method is the same for all three: recall from memory after each lecture, test yourself often, and spread your study out. A review of ten study techniques by John Dunlosky and colleagues (2013) rated practice testing and spreading study out over time as the most useful, and rereading and highlighting as of low use.

1. Download the three syllabi and turn them into a list of topics, subject by subject, to tick off as you go. If you’re already halfway through the semester, do it today and mark what you can already explain from memory and what you can’t.
2. On the day of each lecture, close your notes and write down the main points from memory on a blank page; then check and fill in the gaps in another colour. The corrections are your list of what to review.
3. Turn the facts into short questions, one per line, like the fill-in ones: what the Henderson–Hasselbalch equation gives you, how pressure changes with depth by Stevin’s law, in which phase of mitosis the sister chromatids separate.
4. In Physics and Chemistry do problems every day, not just theory: the Physics syllabus sets aside at least 20 to 30% of each unit for exercises, and calculations on pH, concentrations, gases, fluids and electric circuits are only learned by doing them.
5. In Biology follow processes as chains, from DNA to protein, from a signal to the cell’s response, from mitosis to meiosis: draw them from memory and explain them out loud without notes.
6. Review each topic the next day, then a few days later, then every week or two, and mix the subjects: a quiz with questions from all three is closer to exam day.
7. Keep a log of mistakes: every question you get wrong becomes a line to redo, with why you got it wrong, whether a concept you didn’t know, a slip in a calculation or a question misread.

Spaced review: how far apart, and where Breef helps

How far apart should reviews be? In a study of more than 1,350 people, Nicholas Cepeda and colleagues (2008) found the best gap depends on how long you need to remember: about 20 to 40% of the time until the test when that was a week, and about 5 to 10% when it was a year. With the exam about three months after lectures start, that means reviewing each topic the next day, then a few days later, then every week or two until December, sooner for whatever you get wrong.

Keeping track of that by hand across three subjects is hard, and it’s the work Breef does. You can record a lecture in a note and Breef writes it up as study notes, with sections, key points and what the lecturer stressed. Each note comes back for review the day after, then at gaps fitted to how fast you forget, with three questions written from it; give the course its exam date of 10 December, and every note that would fade by then gets a last review in the days before. “Question :: answer” lines inside a note become cards you can export to Anki, and notes link into a map, handy for seeing where Chemistry and Biology meet. To count the days left and split up the syllabus there are also Breef’s free exam countdown and study planner (breef.app/exam-countdown and breef.app/study-planner).

Practising the format, with a month-by-month plan

Time: 50 minutes for 31 questions is about a minute and a half per question. Go through once answering what you know, then come back to the rest.

Answer or leave blank? With five options and −0.1 per mistake, even a blind guess is worth +0.12 points on average (a fifth of 1 point, minus four fifths of 0.1), and more if you can rule an option out. On fill-in questions it pays to write an answer whenever you have better than a one-in-eleven chance of being right. That’s arithmetic on the scoring, not advice to guess: the aim is to know the answer.

Fill-in questions show you no options to recognise: you have to recall the answer unaided, which is exactly what recall practice trains. For practice there’s the free platform semestreaperto-medodovet.it, promoted by the Conference of Italian University Rectors (CRUI) with the ministry and built by the CISIA consortium, with exercises on the 2026/27 syllabi and, the ministry says, mock exams from November with numbers of questions and timings like the real ones. Questions from the old entrance tests belong to a different exam: use them as a warm-up at most.

Sit mocks as on the day: three 50-minute exams with 30-minute breaks, on paper, starting at 11:00. The plan below is for 2026/27; if you start later, move it to the dates in your year’s decree.

1. Before September: brush up on secondary-school maths, chemistry, physics and biology, which the syllabi take as known; the free platform has self-assessment exercises for exactly this.
2. September: recall from memory after each lecture and questions on each topic, from the first week. Start Physics and Chemistry problems straight away, not in November.
3. October: spaced reviews of everything so far, a mixed quiz across the three subjects once or twice a week, and your mistake log kept up to date.
4. November: the first full timed mocks. Give more days to the units worth the most credits and to those where you go wrong most.
5. The last ten days before 10 December: only recall and mocks; open the book only to fix what you got wrong. The day before, a light review and a full night’s sleep.
6. From 10 December to 11 January: results come out on 23 December. If an exam went badly or the mark is low, prepare it again with the same method for the second sitting: the better mark counts, as long as it is at least 18.
7. After 11 January: results on 20 January, accept or turn down your marks by 23:59 the next day, the ranking on 22 January and enrolment by the 28th.

Common mistakes

Studying one subject at a time and reaching the third in December. The exams are on the same day: the three subjects have to move forward together.

Rereading notes and slides until they look familiar. Familiar isn’t remembered: close everything and recall it.

Doing only theory in Physics and Chemistry. Half the work is calculation, and that’s learned by doing problems.

Practising only multiple-choice questions. Ten of the 31 questions are fill-in, with no option to recognise.

Studying from material that doesn’t follow your year’s syllabus, or skipping units of it. The exams test the syllabus’s objectives.

Treating the second sitting as a postponement. It’s a second chance a month after the first, and in January the three subjects are still examined on one day.

Not checking your personal area on Universitaly. The ranking, your assigned university and the deadlines arrive there, and they count as official notification.