Italy Introduces 'Filter Semester' in Major Medical School Admissions Reform

Italian Ministry of University Reforms Medical Admissions

The Italian Ministry of University has initiated significant changes to the admission process for medical faculties, set to take effect from the 2025-2026 academic year. Spearheaded by Minister of University and Research, Anna Maria Bernini, the reform aims to replace the long-standing national entrance exam with a new system designed to enhance fairness and address the country's pressing need for medical professionals. The decree formalizing these changes was signed on June 4, 2025.

The New 'Filter Semester' System

Under the new system, the traditional entrance test, known as TOLC-Med, will be replaced by an 'open semester' (semestre filtro) for aspiring students in Medicine, Dentistry, and Veterinary Medicine. This initial semester, running from September 1 to November 30, 2025, will be open to all interested students. At its conclusion, students will undertake three national selection exams focusing on core subjects such as biology, chemistry, and physics. Admission to the subsequent years of medical study will then be determined by a national merit ranking based on the results of these exams.

Students wishing to participate must register for the open semester by the end of July 2025 via the Universitaly portal. During registration, applicants are required to indicate up to 10 preferred locations for medical school and 10 alternative degree programs in case they do not qualify for medicine. A registration fee of €250 has been set for the open semester. For those who do not pass the qualifying exams, earned credits from the filter semester can be transferred to other related degree programs, such as Pharmacy or Biotechnology.

Rationale and Objectives Behind the Reform

Minister Bernini has articulated that the reform is founded on principles of 'transparency, fairness, and merit,' aiming to align students' aspirations with the needs of the healthcare system. The Ministry projects training at least 30,000 new doctors over the next seven years to combat the existing shortage. The reform also seeks to overcome the criticisms leveled against the previous system, which was often described as overly selective and reliant on general knowledge rather than specific aptitude. Bernini stated that the reform 'abolishes the restricted number of places in the first semester' and aims to 'discard the lobby of expensive training for university, mnemonic, selective and non-forming tests.'

Concerns and Criticisms

Despite the Ministry's stated goals, the reform has faced scrutiny and opposition. Critics argue that the new system merely postpones the selection process rather than truly abolishing the limited access, creating an 'illusion of open access.' Concerns have been raised regarding the capacity of Italian universities to handle a potentially larger influx of students, citing a lack of faculty, infrastructure, and hospital beds for adequate training. Initial exams held in November 2025 for the filter semester have reportedly shown unexpectedly low pass rates in some northern universities, leading to anxiety among students and criticism from student unions. Furthermore, the reform does not currently apply to English-taught medical courses, which continue with their traditional entrance tests. There are also worries about a potential 'bottleneck' in specialization, as the increase in medical graduates might outpace the availability of specialty training positions.