Italy's Health Professions Admission Test: How It Works

Every year, thousands of students hoping to become nurses, physiotherapists, midwives or other health technicians sit the same test, on the same date, across Italy. It’s the health professions admission test: the entrance exam for capped-enrollment degree programs in the health field, introduced by law 264/1999. It isn’t an exam each university designs on its own — it’s a single national test, with content set every year by a decree from Italy’s Ministry of University and Research (MUR).

A single ministerial test, not a CISIA TOLC

Anyone researching the test often runs into the term TOLC, the family of online tests run by CISIA (the Interuniversity Consortium for Integrated Access Systems) and used by many universities for other degree programs. CISIA’s own official site, however, lists TOLC tests for agriculture and veterinary science, biology, economics, pharmacy, engineering, professionalizing degrees, psychology, science, political and social science, and humanities — nothing dedicated to health professions.

The MUR statements reviewed for this Recap describe something different: a written test held on a single national date, with questions set by ministerial decree and administered directly by universities. That test, not a CISIA TOLC, is the actual gateway into nursing, physiotherapy, midwifery and the other programs in this group. Some universities may ask for a generic TOLC in unrelated situations — off-cycle enrollment, or related programs — but that’s a separate case from ordinary admission to the health professions.

The 2026/2027 format

According to the MUR statement of August 12, 2026, the 2026/2027 test consists of 60 multiple-choice questions, each with five options and one correct answer, to be completed in 100 minutes. The dates set for that academic year were September 16, 2026 for Italian-language programs and September 17, 2026 for English-language programs. The questions break down as follows:

Subject	Questions (2026/2027)
Biology	23
Chemistry	15
Physics and math	13
Logical reasoning and problem-solving	5
Reading comprehension	4
Total	60

Scoring follows a straightforward rule: 1.5 points for each correct answer, -0.4 points for each wrong one, 0 points for a question left blank. The theoretical maximum is 90 points.

A format that changes every year

Comparing two editions of the test shows why every figure in this Recap is tagged with its academic year. The MUR statement of August 1, 2024 described a different test, for the 2024/2025 academic year:

Element	2024/2025	2026/2027
Total questions	80	60
Time allowed	120 minutes	100 minutes
Points per correct answer	1.5	1.5
Points per wrong answer	-0.4	-0.4

The ministerial decree governing the test is renewed each year: the number of questions, the time allowed and the split between subjects can all shift from one edition to the next. Candidates need to check the rules for the year they’ll actually sit the test, not an older edition they happened to find online.

Practical example: a candidate researching the test in 2027 who reads an article from 2024 risks training for 80 questions in 120 minutes, when the test they actually face could have 60 questions in 100 minutes, with a different split between biology, chemistry and the other subjects. Checking the current decree and admission notice — not a past edition — is the first useful step before starting to practice.

How many places are available

For the 2026/2027 academic year, MUR set 39,624 places for bachelor’s-level health-profession degree programs nationwide: 38,184 reserved for EU and non-EU candidates residing in Italy, and 1,440 for non-EU candidates residing abroad. Single-cycle master’s programs received another 4,572 places, 4,443 of them in Italy and 129 abroad.

The national total then splits by university. As one concrete example: for the 2024/2025 test, the University of Florence offered 947 places for EU and non-EU candidates plus 29 reserved for non-EU candidates residing abroad, spread across thirteen programs (605 in nursing, 63 in physiotherapy). That year, 1,743 of 1,840 registered candidates in Florence actually sat the test, with physiotherapy (588 first-choice picks) and nursing (512) the most requested programs.

How the ranked list works

A passing score alone doesn’t secure admission. Each university builds a ranked list — national or local, depending on the program — based on test scores: candidates who land within the number of available places for their chosen program get in, and those who fall outside it don’t, even with a positive score. That’s why it pays to study every subject on the test seriously rather than simply aiming to answer as many questions as possible — a higher score means a better rank. For a broader look at capped enrollment across other degree programs, see the Recap on university entrance exams.

How to prepare

Biology and chemistry carry the most questions in the 2026/2027 test, a reasonable starting point for organizing study time. Anyone who needs to review the basics of biology can start with the structure of the cell; for chemistry, the periodic table remains the go-to tool for navigating elements and their properties. The logical reasoning and problem-solving section also draws on the basics of probability and statistics, useful for reading data and percentages quickly under time pressure.

Timed mock exams are the most direct way to get used to the test’s pace: working through 60 questions in 100 minutes trains time management, which often matters as much as subject knowledge alone. Publishers such as Alpha Test produce question sets modeled on the ministerial exam, useful for practice before the real thing.