Italy: where the degree is the licence and the concorso is the real test

Medical and health education in Italy

Medicine in Italy is a six-year single-cycle Master’s degree (laurea magistrale a ciclo unico, 360 credits) taught in Italian at about forty-five universities, most of them public. Several universities also offer English-language programmes for international students. Entry has recently moved to a first-semester filter system. ANVUR evaluates universities, and the Ministry of University and Research (MUR) sets the framework. Dentistry is six years, pharmacy five, and nursing a three-year degree.

The medical degree is itself a qualifying degree: since a 2018 reform the final exam includes a practical assessment, so the separate state exam (esame di Stato) has been replaced for new graduates. Graduates register with the provincial Order of Doctors (Ordine dei Medici), which is compulsory for practising. Specialist training (scuola di specializzazione) lasts three to six years and is entered through a competitive national exam; GP training runs through a separate regional course. There is no national licensing exam beyond those steps. Non-EU graduates must have their degree recognised by the Ministry of Health and may be asked to take an aptitude test. Confirm current rules with the ministry.

A country where the degree is the licence

Italy used to follow the pattern still common elsewhere: graduate, then sit an Esame di Stato to be allowed to practise. That pattern has been dismantled in stages. The final degree exam now carries the habilitation, so a new doctor, nurse, midwife, pharmacist, dentist or physiotherapist graduates already qualified to register with the professional order. The practical evaluation is built into the degree course, and there is no separate national licensing paper to prepare for.

The result is that Italy's national MCQ market is concentrated at a different point, the specialty-school concorso. For a foreign-trained clinician the difficulty is not an exam but the recognition procedure. The Ministry of Health decides whether your qualification is equivalent, and that decision may come with conditions.

Who needs a licensing exam in Italy

• Italian medicine graduates: no separate licensing exam since the degree became abilitante in 2020. They register with the provincial order, then, if they want specialist training, sit the concorso.
• Nurses, midwives, physiotherapists: the degree is abilitante. The final exam includes a practical test.
• Pharmacists and dentists: abilitante degrees under Law 163/2021. Candidates from earlier cohorts may still need the Esame di Stato.
• Non-EU graduates in any profession: Ministry of Health recognition, possible compensatory measures, and an Italian language exam.

Doctors: the specialty-school concorso

The Concorso nazionale per le Scuole di Specializzazione in Medicina is the main postgraduate entry exam. It consists of 140 multiple-choice questions in about 210 minutes. Results produce a national ranking, and candidates choose specialty schools in rank order. As in France, the aim is allocation, and a high rank carries more value than a pass.

Open to Italian graduates and to recognised medical graduates, it is the exam that most Italian final-year students prepare for, and it is the one that pushes demand for question banks and mock exams. The MUR publishes the call, the programme of topics and the schedule each year, and the format has been changed several times in the past, so the notice of the year you sit is the document to follow.

Foreign-trained doctors

The process runs through the Ministero della Salute (recognition of qualifications, riconoscimento dei titoli).

1. File for recognition with your degree, transcripts, certificate of good standing and certified translations.
2. Receive the decision. Where there are substantial differences, the Ministry requires compensatory measures: an aptitude test (written or oral) or a supervised placement.
3. Pass the Italian language test if it is required of you.
4. Register with the provincial Order of Doctors (Ordine dei Medici) to practise.

Nurses, midwives and physiotherapists

These professions complete a university degree in which the final exam includes a practical test and confers the right to register. There is no further exam. The aptitude test appears only for foreign graduates when the Ministry finds a gap, and it is typically a written or practical assessment of the missing competencies, not a general MCQ exam. Italian proficiency is checked as part of the process. Nurses coming from the Philippines, India and Eastern Europe should plan for the language step first, because clinical work depends on it.

Pharmacists and dentists

Law 163/2021 turned the pharmacy and dentistry degrees into habilitating qualifications. A new graduate registers with the professional order after the final exam. People who graduated under the older rules may still take the Esame di Stato. Foreign graduates follow the same recognition route as doctors: Ministry of Health recognition, compensatory measures where needed, and Italian.

Exams at a glance

Language

All exams and the recognition process are in Italian. The language test for foreign applicants checks that you can work safely with patients, colleagues and records. Italian is the one hurdle that cannot be shortened. Studying clinical vocabulary alongside general Italian is more efficient than learning them in sequence, because the words you need in a ward, such as anamnesi, terapia, referto and cartella clinica, are not those a general course teaches first.

Common mistakes with the Italian route

• Waiting for a licensing exam that does not exist. Candidates sometimes delay registration because they expect an Esame di Stato. For recent medicine graduates there is none.
• Treating the temporary derogation as recognition. Working under the Cura Italia provision does not give you a recognised title, and it may not carry over if you move region or employer.
• Underestimating the paperwork. Translations, legalisation or apostille, and certificates of good standing take weeks. Begin them before you start language classes.
• Preparing for the concorso with old papers only. The programme and structure are set each year in the notice, so use past papers as a style guide and not as a syllabus.

Using this page

For the concorso, work from the MUR notice for your year. For recognition, use the Ministry of Health pages and speak to the provincial order. We have summarised rules that are updated by decree, and TriagePass is independent of every Italian authority.

Last reviewed October 2026