Charges by Italian health minister Girolamo Sirchia that jobs in medical schools are "hereditary" have been supported by a ruling in the courts.
Judges have cancelled the appointment of a specialist to a medical teaching post, in a landmark case.
Dr Sirchia claimed in February that "teaching posts still go to sons and daughters and brothers-in-law", awarded through the system of concorsi (competitive exams), under which candidates apply for a job before a selection panel of senior academics.
Dr Sirchia failed to respond to a challenge from rectors to name names. But a Sardinian court cancelled the nomination of Roberto Puxeddu, an ear, nose and throat specialist, to a post as associate professor at the University of Cagliari and ordered the university to pay €3,000 (£2,000) in costs.
The judges upheld a complaint from a candidate who had better qualifications than Dr Puxeddu, declaring there was "illegitimacy produced by lack of impartiality".
The court heard that the panel that gave Dr Puxeddu the job included two professors who had been given their posts in 1988 in a concorso by a panel presided over by Dr Puxeddu's father, Paolo, who also teaches at Cagliari.
That concorso had already been ruled irregular by another court that described "power... interests which were brazenly nepotistic" and gave Paolo Puxeddu a suspended sentence of one year.