The 18-to-30 Grading Scale in Italian Med School

The IMAT trains you to think in one specific kind of number: a raw score out of a fixed maximum, correct answers minus penalties for wrong ones. Once you're actually enrolled, that entire logic disappears, and almost nobody explains the replacement before you're sitting in front of your first result wondering if you should be worried.

The short answer: Italian universities grade every exam on an 18-to-30 scale. Eighteen is a pass, thirty is the top ordinary grade, and a number like 22 is a solid result, not a warning sign.

The 18-to-30 scale, and what each number actually means

Eighteen is the minimum passing grade on any single exam. Thirty is the highest ordinary grade, and thirty e lode, "with honors," is a step above that reserved for genuinely exceptional performances. There's no letter grade system running alongside it and no percentage conversion posted anywhere, the number itself is the whole result for that one exam, not a average pulled from a full semester of assignments.

How a single exam grade actually gets decided

Most exams combine a written component with an oral one, and the two get folded into that final number by the professor, not calculated by a formula. That means the same exam can feel noticeably different depending on who's examining you that session, which is part of why students compare notes on specific professors as much as they compare notes on the material itself.

Why the scale surprises people who come from percentage systems

A 22 sounds low if your instinct is to read it as 22 percent. It isn't. Twenty-two out of thirty is a comfortable pass, well clear of the eighteen minimum, and plenty of students graduate with an average sitting somewhere in the mid-to-high twenties without it reflecting badly on them at all. The scale simply compresses differently than what most candidates are used to, and it takes a semester or two before a number like that stops triggering panic.

What actually matters for your degree in the long run

Your running average does eventually factor into things further down the line, including how competitive your application looks when it's time to choose a medical specialization later on. But one lower grade early on, especially in a notoriously hard first-year exam, is not the crisis it feels like in the moment, and it's usually possible to retake an exam to improve it if the result genuinely doesn't reflect your level. A grade below 18 just means sitting the exam again at a later appello, which we cover in how exam sessions actually work.

Nobody walks in already fluent in a grading system this different from the one they just spent months preparing for. Knowing what the numbers actually mean before you see your first one is most of the battle.