THE INTERNATIONAL MEDICAL ADMISSIONS TEST

(IMAT) SPECIFICATION

In partnership with Ministero dell'Istruzione, dell'Università e della

Ricerca (MIUR), the Italian Ministry of Higher Education and
Research
September 2020

The International Medical Admission Test (IMAT)

The International Medical Admissions Test (IMAT) is a
subject-specific admissions test in English, designed by Cambridge
Assessment, for applicants to Medicine and Surgery courses at
Italian International Medical Schools.
These courses are taught in English, with places open to both home
and international students. Cambridge Assessment works in
conjunction with the Italian Ministry of Higher Education and
Research (MIUR) to develop and deliver IMAT, which is the
English language equivalent of the Italian admissions test used for
entry to medical degrees taught in Italian.

Test Specification
Test Format
IMAT is a pen-and-paper test, consisting of a total of 60
multiple-choice questions divided into four sections. All questions
have five options, of which only one is correct. Candidates have 100
minutes to complete the test and the format is as follows:
Section 1
10 questions - Logical Reasoning 12 questions - General Knowledge
Section 2
18 questions - Biology
Section 3
12 questions - Chemistry
Section 4
8 questions - Physics and Mathematics
Scoring
A candidate’s total score is calculated using the following formula:
1.5 points for each correct answer; -0.4 points for each wrong
answer; 0 points for each question not answered.
An overall total score (maximum 90 points) will be reported,
together with a score on each of Logical Reasoning, General
Knowledge, Biology, Chemistry, Physics and Mathematics.
Level of Difficulty
The level of difficulty of the test items will be targeted to
discriminate effectively between applicants, including those who
may have achieved the highest possible grades in school
examinations.

Section 1: General Knowledge and Logical Reasoning

Section 1 will assess general knowledge and the thinking skills that
students must possess in order to succeed in a course of study at the
highest level. Such skills are basic to any academic studies, which
often require students to solve novel problems, or consider
arguments put forward to justify a conclusion, or to promote or
defend a particular point of view.
General Knowledge
General Knowledge questions may address a range of cultural
topics, including aspects of literary, historical, philosophical, social
and political culture.
These questions are not based on any specific part of school
curricula; rather their aim is to test the candidates’ interest and
knowledge in a wide variety of fields. Candidates with a keen
extra-curricular interest in current events who regularly keep up to
date with national and international news will be better prepared to
answer this type of question.
Which country was governed by the Taliban’s theocratic regime
from 1996 to 2001?
. A Afghanistan
. B Iran
. C Iraq
. D Saudi Arabia
. E Syria
Here the correct answer is A. Logical Reasoning
The questions in this section evaluate candidates’ thinking skills,
reasoning skills and analytical skills, especially the ability to follow
the logical steps in different contexts, to recognise fallacies in the
argument, to solve problems, and to discern relevant from irrelevant
information.
More specifically, there are two types of logical reasoning
questions:
• Critical thinking: questions that involve reasoning using everyday
written language. Questions focus on the skills involved in
understanding and evaluating arguments.

• Problem Solving: questions that involve reasoning using numerical

and spatial skills. In order to successfully answer these
questions, candidates must employ a logical approach. No
previous knowledge of any particular subject is necessary and
all the information required to answer them is included in the
question. Candidates are strongly encouraged to familiarize
themselves with the different types of questions by reading this
guide.

Critical Thinking
In this category there are 7 different specific types of questions that
can appear in this section of the test:
1. Summarising the main conclusion

2. Drawing a conclusion

3. Identifying an assumption

4. Assessing the impact of additional evidence

5. Detecting reasoning errors

6. Identifying parallel reasoning

7. Applying principles

1. Summarising the Main Conclusion

There has been a decline in the rate of many of the illnesses of old
age. The causes of this decline include such medical advances as
new drugs and surgical techniques. There is, however, another
factor. The present generation of 60- and 70-year-olds had much
better nutrition as children than did their parents. Good nutrition in
childhood is important for good health in adulthood. Since
improvements in nutrition have continued over the past sixty years,
we can expect that many of the illnesses of old age will continue to
decline.
Which one of the following best expresses the main conclusion of
the above argument?
. A We can expect that improvements in nutrition will continue.
. B The rate of many of the illnesses of old age has declined.
. C Medical advances have significantly reduced the rate of
diseases of old age.
. D The fall in the rate of many of the illnesses associated with old
age will continue.
. E Improvements in nutrition have been very important in
maintaining good health in old age.
In this type of question you have to judge which one of the
statements A to E best expresses the main conclusion of the
argument. The conclusion can appear anywhere within an argument
- not necessarily at the end. What you are looking for is the
statement which follows from, or is supported by the rest of the
passage.
In this case, D is the correct answer.
2. Drawing a Conclusion
The demand for blood donors is increasing all over the world. In
Western countries, in particular, demand has been rising so rapidly
that shortages have begun to appear. In all such countries, demand is
growing much faster than rates of growth in populations aged
18–65, and it is this group who are the major blood donors. And,
despite a massive research effort to find alternatives, it remains true
that in medicine there is no substitute for human blood.
Which one of the following conclusions can be drawn from the
passage?
. A As the demand for blood has increased, so has the supply
fallen.
. B The rate of growth of the blood-donor population has been
slowing recently.
. C The increase in the rate of demand for blood is mainly due to
population growth.
. D If more blood donors could be found, there would be no need
to find a substitute for human blood.
. E The problem of the increase in demand for blood shows no sign
of disappearing.
In this type of question you are asked which conclusion follows
from the information given. You need to consider each of the
statements A to E, and to think about whether the information in the
passage gives you good reasons to accept the statement.
In this case, E is the correct answer. 3. Identifying an Assumption
Success in modern America is very much measured by the quantity
of material possessions one has. A lack of material possessions
means one is judged to be unsuccessful. Those people with few
material possessions therefore must feel a strong sense of failure.
Which one of the following is an underlying assumption of the
above argument?
. A Most modern Americans are successful.
. B Success can be precisely measured.
. C People in America with few material possessions want to be
seen as successful.
. D Excessive desire for material possessions is psychologically
damaging.
. E Over-emphasis on material possessions creates social
problems.
An assumption is something which is not stated in the argument, but
which is taken for granted in order to draw the conclusion. So you
need first to identify the conclusion of the argument. Then look for
the reasoning it gives to support this conclusion, and think about any
important point which is not actually stated in the reasoning.
In this case, C is the correct answer.
4. Assessing the Impact of Additional Evidence
Zoos are entirely unsuitable places for animals. People visit zoos to
learn about animal behaviour but the animals they see are likely to
be behaving in abnormal and neurotic ways because of the cramped
and unnatural conditions in which they are kept. Zoos should be
closed and the money saved should be used for the protection of
natural habitats.
Which one of the following, if true, would most weaken the above
argument?
. A Humans living in cramped conditions can also become neurotic
. B Zoos enable endangered species to survive by breeding them in
captivity and then re- introducing them to the wild
. C Many of the animals at present in zoos would not be capable of
living in the wild
. D The protection of natural habitats is very costly
. E Schoolchildren can learn a great deal about animals from
visiting zoos
This type of question will typically ask you to consider what would
weaken or strengthen an argument. You need first to be clear about
what the argument is trying to establish. Work out what the
conclusion is, and then consider what effect each of the possible
answers would have on the conclusion.
In this case, B is the correct answer. 5. Detecting Reasoning
Errors
In order to succeed in academic examinations it is necessary to
study. Therefore, if a student works hard in a particular subject, he
or she should do well when it comes to the examination.
Which one of the following best describes the flaw in the argument?
. A It assumes that it is necessary to study in order to succeed.
. B It overestimates the value of studying in preparation for
examinations.
. C It ignores the fact that some subjects are more academic than
others.
. D It assumes that studying hard is a sufficient condition for
academic success.
. E It ignores the fact that some students do not need to study very
much in order to succeed.
This type of question asks you to identify the flaw in the argument,
which means that you must explain why the conclusion does not
follow from the reasons which are given. So you need to be clear
about what the conclusion is, and what reasons are meant to support
it.
In this case, D is the correct answer.
6. Identifying parallel reasoning
If you want to earn a good salary these days, you have to gain
considerable experience of working abroad. Since I have always
wanted to earn a huge salary, it’s obvious that I’m going to have
leave this country for some period of time.
Which one of the following most closely parallels the reasoning
used in the above argument?
. A If I had more time to spend on this project, I know that it would
be very successful. I’ve been told that I’m not going to be
given enough time, so the project isn’t going to succeed.
. B Sam knew that if he wanted to write a film script, he would
have to learn the special techniques needed for such scripts. He
has enrolled on a course to learn how to write them, so he’ll
soon be writing his first script.
. C If the Ambassador can bring the two sides together for talks,
there’s a good chance of peace. Peace is something that both
sides want, so he’ll be talking to both sides soon.
. D If the doctor thinks that you should be allowed out of bed for a
short while, then you must be recovering well from your
 operation. You have recovered much quicker than she thought
you would, so you’ll be out of bed a lot from now on.
. E Annie says that it she really wants to win the race, she‘ll have
to train very hard every day. She told me that she is determined
to win the race, so that means she’ll be working hard on her
training programme every day from now on.
This type of question asks you to identify similar arguments, but not
similarity of topic. You need to look for similarity in the structure or
pattern of the argument. So you must identify the structure of the
argument and then consider each option to identify an argument
with the same structure.
Here the correct answer is E.
7. Applying Principles
Smokers who suffer from heart disease which is caused by their
smoking should not be allowed to get free health treatment. That is
because this is an example of self-inflicted illness. Those whose
actions have caused illness or injury to themselves should make a
financial contribution to their treatment.
Which one of the following best illustrates the principle underlying
the argument above?
. A Children should get free dental treatment, even if they eat
sweets which cause dental decay.
. B Motor cyclists whose head injuries are caused by not wearing a
crash helmet should make a financial contribution to their
treatment.
. C Smokers who cannot afford to pay for healthcare should be
allowed free treatment when they are ill.
. D People who are injured in car accidents should receive free
treatment regardless of whether they were wearing a seat belt.
. E Heart disease sufferers who can afford to pay for health
treatment should not receive free treatment.
This type of question asks you to identify which statement illustrates
the principle underlying the passage. A principle is a general
recommendation, which in the passage will be applied to just one
particular case, but which could also be applied to other cases. In
order to answer this type of question, you must first identify this
principle and then consider each of the options to see which one
follows from that principle.
The correct answer is B.
Problem Solving
There are three kinds of problem solving questions:
1. Relevant Selection

2. Finding Procedures

3. Identifying Similarity

Although most questions fall into only one category, some questions
fit into more than one of the categories.
1. Relevant Selection
The following table gives figures for the percentage growth per year
of labour productivity per person per year in various countries
during three periods.
Japan
France
Sweden
Period 1
Period 2
3.0
Period 3
8.5
3.0
3.2
5.4
2.6
United Kingdom
Belgium
3.6
1.5
2.8
2.4
3.3
2.3
4.1
1.5
1.8
Denmark
Netherlands
Germany
United States
4.3
2.2
2.6
0.0
1.7
Italy
6.3
4.8
3.0
2.7
1.6
1.6
4.5
3.1
1.6
0.8
Which country's percentage growth per year remained consistently
greater than half of its Period 1 level in the following periods?
. A Belgium
. B Denmark
. C France
. D Germany
. E United Kingdom
Very often a real world problem will be overloaded with
information, much of which is unimportant. This kind of question
demands Relevant Selection, in which the task is to select only that
information which is necessary and helpful in finding a solution.
In this case, A is the correct answer.
2. Finding Procedures
A child's bus fare is cheaper than the adult fare but is more than half
the adult fare. The total cost of a single journey for an adult and two
children is €1.20. Adult fares are all multiples of 10 cents.
What is the adult fare?
. A 30 cents
. B 40 cents
. C 50 cents
. D 60 cents
. E 70 cents
Sometimes you will find that even if you have selected all the
relevant information, no solution presents itself. For this type of
question, you have to find a method or procedure which you can use
to generate a solution.
In this case, C is the correct answer. 3. Identifying Similarity
I wish to tile an area of wall 120 cm wide by 100 cm high. Tiles are
20 cm square. I will, therefore, need 6 x 5 = 30 tiles.
Which one of the following uses the same method of calculation as
that above?
. A A staircase is 3 m high. Each step rises 0.25 m. Therefore,
there are 12 steps.
. B A room is 4.2 m by 2.0 m. Carpet costs €10.00 per square
metre. Therefore, it will cost €84.00 to carpet the room.
. C Aboxcontainingsugarcubesis10cmx10cmx5cm.Asugarcubeis1c
mon each side. Therefore, the box contains 500 cubes.
. D Using square tables 1.5 m on each side, I need to make up a
conference table 6 m x 3 m. Therefore I will need 8 tables.
. E I work 40 hours a week and earn €5.00 an hour. Therefore, in 4
weeks I will earn €800.00.
In this type of question you will be presented with information and
asked to identify the same information presented in a different way,
or a situation in which different information has a similar structure.
Here the correct answer is D.

Section 2: Biology Topics covered:

The chemistry of living things
The biological importance of weak interactions. Organic molecules
in organisms and their respective functions. The role of enzymes.
The cell as the basis of life
Cell theory. Cell size. Prokaryotic and eukaryotic cells, animal and
plant cells. Viruses. The structure and function of the cell membrane
and transport across the membrane. Cellular structures and their
specific functions. Cell cycle and cell division: mitosis and meiosis -
chromosomes and chromosome maps.
Bioenergetics
The energy currency of cells: ATP. Redox reactions in living things.
Photosynthesis, glycolysis, aerobic respiration and fermentation.
Reproduction and Inheritance
Life cycles. Sexual and asexual reproduction. Mendelian genetics:
Mendel's laws and their applications. Classical genetics:
chromosomal theory of inheritance - inheritance patterns. Molecular
genetics: structure and replication of DNA, the genetic code, protein
synthesis. Prokaryotic DNA. Eukaryotic chromosome structure.
Genes and regulation of gene expression.
Human genetics: mono- and multifactorial character transmission;
hereditary diseases - autosomal and linked to chromosome X.
Biotechnology: recombinant DNA technology and its applications.
Inheritance and environment
Mutations. Natural and artificial selection. Evolutionary theories.
The genetic basis of evolution.
Anatomy and physiology of animals and humans
The animal tissues. Anatomy and physiology of systems in humans
and their interactions. Homeostasis.

Section 3: Chemistry Topics covered:

The composition of matter
States of matter; heterogeneous and homogeneous systems;
compounds and elements. Ideal Gas Laws.
Atomic structure
Elementary particles; atomic number and mass number, isotopes,
electronic structure of atoms of different elements.
The periodic table of the elements
Groups and periods; transition elements. Periodic properties of
elements: atomic radius, ionization potential, electron affinity,
metallic character. The relationships between electronic structure,
position in the periodic table, and element properties.
The chemical bond
Ionic, covalent and metallic bonds. Binding energy. Polarity of
bonds. Electronegativity. Intermolecular bonds.
Fundamentals of inorganic chemistry
Nomenclature and main properties of inorganic compounds: oxides,
hydroxides, acids, salts.
Chemical reactions and stoichiometry
Atomic and molecular mass, Avogadro's number, mole concept and
its application, elementary stoichiometric calculations, balancing
simple reactions, different types of chemical reaction.
Solutions
Solvent properties of water, solubility, the main ways of expressing
the concentration of solutions. Equilibria in aqueous solution.
Chemical kinetics and catalysis.
Oxidation and reduction
Oxidation number, concept of oxidizing and reducing. Balancing of
simple reactions.
Acids and bases
The concept of acid and base. Acidity, neutrality and basicity of
aqueous solutions. The pH scale. Hydrolysis. Buffer solutions.
Fundamentals of organic chemistry
Bonds between carbon atoms, and crude formulas of structure, the
concept of isomerism. Aliphatic, alicyclic and aromatic
hydrocarbons. Functional groups: alcohols, ethers, amines,
aldehydes, ketones, carboxylic acids, esters, amides. Chemical
nomenclature.

Section 4: Physics & Mathematics

Physics
Topics covered: Measures
Direct and indirect measures, fundamental and derived quantities,
physical dimensions of quantities, knowledge of the metric system
and the CGS System of Units, Technical (or practical) (ST) and
International System (SI) units of measurement (names and
relationships between fundamental and derived units), multiples and
sub-multiples (names and values).
Kinematics
Kinematic quantities, various types of motion with particular regard
to uniform and uniformly accelerating rectilinear motion; uniform
circular motion; harmonic motion (for all motions: definition and
relationships between quantities).
Dynamics
Vectors and vector operations. Forces, moments of forces about a
point. Moment of a force couple. Vector composition of forces.
Definition of mass and weight. Acceleration due to gravity. Density
and specific gravity. The law of universal gravitation, 1st, 2nd and
3rd laws of motion. Work, kinetic energy, potential energy.
Principle of conservation of energy. Impulse and momentum.
Principle of conservation of momentum.
Fluid mechanics
Pressure, and its unit of measure (not only in the SI system).
Archimedes’ Principle. Pascal's principle. Stevino's law.
Thermodynamics
Thermometry and calorimetry. Thermal capacity and specific heat
capacity. Modes of heat propagation. Changes of state and latent
heats. Ideal Gas Laws. First and second laws of thermodynamics.
Electrostatic and electrodynamics
Coulomb's law. Electric field and potential. Dielectric constant.
Capacitors. Capacitors in series and in parallel. Direct current.
Ohm’s Law. Kirchhoff’s Principles. Electrical resistance and
resistivity, electrical resistances in series and in parallel. Work,
Power, Joule effect. Generators. Electromagnetic induction and
alternating currents. Effects of electrical currents (thermal, chemical
and magnetic).
Mathematics
Topics covered:
Algebra and numerical sets
Natural numbers, integers, rational and real numbers. Sorting and
comparison: scales and scientific notation. Operations and their
properties. Proportions and percentages. Powers with integer and
rational exponents, and their properties. Roots and their properties.
Logarithms (base 10 and base e) and their properties. Elements of
combinatorics. Algebraic and polynomial expressions. Major
products and nth power of binomial expansions, factorisation of
polynomials. Algebraic fractions. Algebraic equations and
inequalities of the first and second order. Systems of equations.
Functions
Basic concepts of functions and their graphical representations
(domain, codomain, sign, continuity, maxima and minima,
increasing and decreasing, etc.). Elementary functions: whole and
fractional algebraic functions; exponential, logarithmic, and
trigonometric functions. Composite and inverse functions.
Trigonometric equations and inequalities.
Geometry
Polygons and their properties. Circle and circumference.
Measurements of lengths, surfaces and volumes. Isometries,
similarities and equivalences in the plane. Geometric loci.
Measurement of angles in degrees and radians. Sine, cosine, tangent
of an angle and their significant values. Trigonometric formulas.
Solving triangles. Cartesian reference system in a plane. Distance
between two points and the midpoint of a segment. Straight line
equation. Conditions for parallel and perpendicular lines. Distance
of a point to a line. Equation of the circle, the parabola, the
hyperbola, the ellipse and their representation in the Cartesian plane.
Pythagoras’ theorem. Euclid’s first and second theorems.
Probability and statistics
Frequency distributions and their graphical representations. Concept
of random experiments and events. Probability and frequency.

Specimen Biology, Chemistry, Physics and Mathematics

Questions
The diagram below shows a family tree of a condition known as nail
patella syndrome (NPS).
12
345 6
789 Key
female without NPS female with NPS
male without NPS male with NPS
Which of the following pairs of individuals must be heterozygous
for NPS?
A 1and5 B 2and6 C 3and7 D 4and8 E 5and9
Here the correct answer is D.

An oxide of iron has the formula Fe3O4 and contains both Fe2+ and
Fe3+ ions. Which one of the following is the fraction of iron ions
that are in the Fe2+ state?
1/ 1/ 1/ 2/ 3/
4 3 2 3 4
ABCDE
Here the correct answer is B.
Below are four statements about thermal (heat) energy.
1 A substance can lose heat energy without its temperature falling. 2
Heat energy can pass through a vacuum. 3 Steam at 100oC has more
heat energy than the same mass of boiling water at 100 oC 4 When a
container of water is cooled near the top, a convection current is set
up in the water.
Which statements are correct?
A 1,2and3only B 2,3and4only C 1,2and4only D 1,3and4only E
1,2,3and4
Here the correct answer is E.
The longest side of a right angled triangle is 6 + One of the shorter
sides is 3 + 2 5 units. What is the length of the third side?
A23
5 units.
70+24 5 C 12
D3−5E 14+7.5 5
B
Here the correct answer is A.
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