Medicine: End of the Closed-Number System?

The closed-number system for medicine will not be abolished. The news claiming that it has been eliminated is false because free access will only apply to the first semester. After that, selection will take place through a national ranking system.

With this clarified, here are the most critical aspects of the 2025 medical school entrance exam reform.

Medical School Closed-Number System: What We Know

The information available comes from the amended Consolidated Text, now a Delegated Bill (for details on accepted and rejected amendments, visit the Senate website), and from the Ministry of University and Research (MUR) press release:

• Open access to medical school will only apply to the first semester.
• During the first six months, students will take core exams and qualifying subjects common to biomedical, health, pharmaceutical, and veterinary programs.
• To access the second semester, students must complete all required credits (CFUs) for first-semester exams conducted under uniform standards and achieve a qualifying rank in the national merit ranking.
• Students who do not qualify for the second semester of medicine, dentistry, or veterinary programs—or those who obtain the required CFUs in other degree programs and wish to transfer—can retake the first-semester exams in subsequent years if their scores are insufficient for selection.
• The reform also includes guidance initiatives during the final years of high school, with specific pathways to facilitate entry into degree programs.

Goodbye to the Medical School Entrance Exam: What We Don’t Know

When will the closed-number system for medicine be abolished? Not in 2025. This is certain, but many questions remain:

• We still don’t know which subjects will be considered core. In the past, anatomy, chemistry, medical physics, and biology were mentioned, but programs could also include biochemistry and genetics.
• Exams must follow uniform standards. What does this mean? Will there be a national quiz for each exam, effectively replacing the single entrance exam with multiple national tests? Conducting oral exams for over 60,000 students would be challenging.
• The criteria for the national merit ranking, aside from CFUs, are unclear. Will factors like exam grades, age, or other elements be considered? If exam grades matter, students will need to pass 3-4 exams within six months with high scores—difficult for subjects like anatomy.
• Will students already enrolled in biology, pharmacy, or chemistry have an advantage? They may have already completed these exams, making them better prepared than recent high school graduates.
• Universities may lack the infrastructure to accommodate large numbers of students. Will online universities be used?

Medical School Reform 2025: Funding Challenges

During the Senate session on October 17 (see transcript on the Senate website), Senator Castellone highlighted that:

"Since proposals for additional funding were rejected and spending limits remain unchanged, the current teaching staff is entirely insufficient given the significant increase in first-semester enrollments. This could justify the use of online universities, potentially compromising education quality."

Senator Verducci also mentioned:

"A budget cut of over 800 million euros from the university funding pool, alongside an imminent decree that reportedly favors online universities at the expense of public universities."

Furthermore, guidance initiatives in high schools must be implemented at zero cost. The bill states:

"Promote… without new or additional public financial burdens… orientation pathways for the last three years of high school."
"Promote, without new or additional public financial burdens, extracurricular training and preparation programs for master's degree courses."

Medical School Spots in 2025

How many spots will be available? Journalistic sources suggest an increase to 25,000. However, those familiar with the system know that this number includes various categories.

Last year, the Minister posted on Instagram:

"Medical school spots are increasing. A promise we are keeping. I have signed the decrees for the 2024/25 academic year, allowing nearly 21,000 new enrollments—over 1,200 more than last year."

However, this figure included private universities, non-EU students residing abroad, and English-language medical programs. The actual number of spots available for EU and equivalent non-EU students in public universities was 14,823, not 21,000.

Therefore, while an increase to 18,000 is plausible, reaching 25,000 is unlikely. Meanwhile, with free access in the first semester, enrollment numbers could hit record levels.

Medical School Test Reform: What Happens Next?

The proposed reform is still a Delegated Bill, meaning it could undergo significant changes, and the final text’s approval timeline is uncertain. The process includes:

1. Submission of amendments to the bill by November 21 (see text here).
2. Presentation to the Senate plenary assembly for voting on November 26 (see Senate proceedings here).
3. Review by the Chamber of Deputies and, if amended, further evaluation by the Budget Committee.
4. Approval by the Chamber of Deputies.
5. Implementation of ministerial decrees by the MUR, subject to parliamentary review.
6. Once finalized, the reform will take effect.

If this process is not completed in time, the current medical school entrance exam will remain in place for 2025.

How to Prepare for Medical School Admission in 2025

Unfortunately, the situation remains highly uncertain, with only a few clear points and many missing details.

Regardless of whether an entrance exam is required, prospective medical students will need a strong foundation in subjects like chemistry, biology, and anatomy.

Instead of answering 15 chemistry questions, students may now face a full university exam on the subject!