Counties with over urban population are Hunedoara, Brașov and Constanța, while those with less than a third are Dâmbovița (30.06%) and Giurgiu and Teleorman. Bucharest is the capital and the largest city in Romania, with a population of over 1.8 million in 2011. Its larger urban zone has a population of almost 2.2 million, which are planned to be included into a metropolitan area up to 20 times the area of the city proper. Another 19 cities have a population of over 100,000, with Cluj-Napoca and Timișoara of slightly more than 300,000 inhabitants, Iași, Constanța, Craiova, and Brașov with over 250,000 inhabitants, and Galați and Ploiești with over 200,000 inhabitants. Metropolitan areas have been constituted for most of these cities. Education Since the Romanian Revolution of 1989, the Romanian educational system has been in a continuous process of reform that has received mixed criticism. In 2004, some 4.4 million individuals were enrolled in school. Of these, 650,000 were in kindergarten (three-six years), 3.11 million in primary and secondary level, and 650,000 in tertiary level (universities). In 2018, the adult literacy rate was 98.8%. Kindergarten is optional between three and five years. Since 2020, compulsory schooling starts at age 5 with the last year of kindergarten (grupa mare) and is compulsory until twelfth grade. Primary and secondary education is divided into 12 or 13 grades. There is also a semi-legal, informal private tutoring system used mostly during secondary school, which prospered during the Communist regime. Alexandru Ioan Cuza University of Iași, Babeș-Bolyai University of Cluj-Napoca, University of Bucharest, and West University of Timișoara have been included in the QS World University Rankings' top 800. Romania ranks fifth in the all-time medal count at the International Mathematical Olympiad with 316 total medals, dating back to 1959. Ciprian Manolescu managed to write a perfect paper (42 points) for a gold medal more times than anybody else in the history of the competition, in 1995, 1996 and 1997. Romania has achieved the highest team score in the competition, after China, Russia, the United States and Hungary. Romania also ranks sixth in the all-time medal count at the International Olympiad in Informatics with 107 total medals, dating back to 1989. Healthcare Romania has a universal health care system; total health expenditures by the government are roughly 5% of GDP. It covers medical examinations, any surgical operations, and any post-operative medical care, and provides free or