Vitaliano said more or less everything.However, I d like to call your attention on a couple of more things.
First of all, when i took the entrance exams in Rome(5 years ago), there was also a"logic" session in the exam, which actually made up a big part of the questions.This means your Italian knowledge has to be very good to do that.
Second, a part of you grade is made up by your high school degree.
Suprisingly, all the Italians i saw there had a flawless score in high school(20/20). And i m saying suprisingly, because during the exam they were asking me for the answers in all the topics except for the language part. That s right, cheating was free during the exam!! Only problem was, the Italians wouldn t help any foreigners(logical, since we were fighting for a common number of places).
Third, there s an oral exam, passing which allowed you to enter automatically Biology or Pharmacology school, and if you wanted, to enter a written exam, to go for medical school. The oral exam was ridiculously easy.
Fourth, if you DO go to Italy, avoid by any means southern schools. There is an amazing degree of corruption there, Napoli being the golden standard.You may find easily a way to enter med school without studying, and other ways to finish it, without studying(actually, this way is called lirette, the national currency).
Overall, I would tell you to keep Italy as a secondary option. There are very good schools(hell, Milan has the reputation of being the very best in Europe), but in general things aren t good, especially for foreigners.When i had my oral exam, first thing the guy told me when he saw i was Greek was"what s wrong with you Greeks, you want to make a colony here?" Plus, in a big study i happened to read 4 years ago, Italian doctors had one of the biggest(if not the biggest) percentages in false diagnoses in Europe.
Hope this was helpful.
Later...