Immigration, Refugees and Citizenship Canada (IRCC) of Canada will make a major change to the Express Entry system of permanent residency (PR) applications. Before applying as a PR, the applicants are required to undergo an Immigration Medical Exam (IME). This is a change from the former process, in which medical exams were requested following the submission of the application.
What Is the Reason Why Canada Is Making This Change?
The IRCC wants to simplify the Express Entry process by demanding pre-medical examinations. The change will aim at:
- Minimize Delays in Processing: With medical results available at the moment of application, IRCC can make faster decisions, which can save weeks or months of processing time.
- Increase Efficiency: Pre-submission medical exams enable IRCC to determine medical admissibility prior to submission, eliminating back-and-forth communication.
- Promote Public Health and Safety: The exams assist in determining the conditions that may be hazardous to the health of the population or that may burden the Canadian health system.
This revision is only in the Express Entry streams, including the Federal Skilled Worker Program, Canadian Experience Class, and Federal Skilled Trades Program. Family sponsorships or refugee claims are other ways of immigration and are not affected. Applications received prior to August 21, 2025, use the old procedure, in which medical examinations are ordered after the application is received.
Who Should Take the Medical Exam?
The new regulation requires that every person who is part of an Express Entry PR application (the principal applicant and his or her dependents (spouse, children, etc.) must have an IME, even when the dependents do not intend to immigrate to Canada. This makes all of them medically admissible under the Canadian immigration law.
Exemptions
Exemptions are few. You may not be required to take a new medical exam, provided you are applying in Canada, and have had an IRCC-approved medical exam in the past five years (e.g. a study or work permit). With your application, you will need to enter your previous IME number or medical identifier (a unique code that IRCC issues). IRCC will examine the validity of the previous exam and will notify you whether you need a new one. To prevent delays, always check with IRCC.
The Importance of Medical Admissibility
Canada has stringent medical admissibility requirements to safeguard the health of the population and to control health expenditures. There are two main reasons why an applicant can be found to be inadmissible:
- Public Health Risks: The presence of such conditions as untreated tuberculosis (TB), active syphilis, or other infectious diseases that might pose a threat to the health of the population may result in refusal. As an illustration, a chest X-ray, which is usually a requirement, is used to screen TB.
- Unreasonable Demand on Healthcare: In case a condition is expected to exceed the amount of $27,162 CAD per year (three times the per capita health expenditure in Canada), it may lead to denial. This involves continuing care, drugs or long-term care.
Nevertheless, refusal is not caused by all chronic conditions. An example is conditions such as diabetes or hypertension that are well controlled and where the applicant is on a treatment regimen and would not cause much healthcare burden. The cases are evaluated on a case-by-case basis, and IRCC takes into consideration such factors as the availability and cost of treatment in Canada.
The Immigration Medical Exam: What to Expect
An IME should be performed by a panel physician approved by IRCC. They are registered physicians who are certified by IRCC to conduct immigration medical examinations. This is not something you can go to a common clinic or your family doctor. This is what normally takes place during the exam:
- Medical History Review: The doctor will enquire about previous surgeries, chronic illnesses, and medications being taken.
- Physical Examination: This involves examining your heart, lungs, eyes, ears and your general physical well-being.
- Diagnostic Tests:
- Chest X-ray: A requirement to most applicants in order to screen for TB.
- Blood and Urine Tests: These tests for diseases such as HIV, syphilis, or kidney problems.
- Mental Health Screening: A simple examination to determine mental health status that may affect admissibility.
- Vaccination Verification: You will be required to show evidence of vaccinations (e.g. measles, polio). Lost vaccinations can be updated prior to the exam.
What to Bring
In order to facilitate a smooth process, please carry the following to your appointment:
- A government-issued ID (preferably a passport).
- Past medical history or test results, in case they exist.
- A list of medications in use.
- Vaccination certificates.
- Four recent passport-size photographs (inquire with the doctor on the specifications).
What Will It Cost?
An IME can cost between countries, clinics and tests required. You will pay on average between 140 and 280 CAD per person. This covers:
- The fee of the panel physician.
- Laboratory work (blood and urine).
- Chest X-ray.
- Any specialist referrals, where necessary.
This is out of pocket, as IRCC does not cover or reimburse the cost of medical exams. Plan your budget, particularly when you are applying with dependents because expenses can pile up fast.
Reserving Your Immigration Medical Exam
To schedule your IME, follow these steps:
- Go to the IRCC Panel Physician list at the official IRCC site.
- To locate an approved panel physician, select your country and city.
- Call the doctor to make an appointment.
- Write the exam and then apply through an Express Entry PR application.
It is prudent to make a booking early because the availability of appointments may be different, particularly in busy locations. Make sure that the exam is taken within the validity period (usually one year) so that there is no need of taking a repeat exam.
Hints to a Smooth Process
- Plan Ahead: Book your IME early to allow time in case there is a delay in making the appointment or getting test results.
- Verify Physician Credentials: The exam can only be done by IRCC-approved panel physicians. Check their status on the IRCC site.
- Documentation: Save a copy of your medical examination results and identifiers in digital and hard copy formats to use in your application.
- Check Health Conditions: In case you have a chronic illness, you should ensure that it is well under control because it will enhance your chances of admission.
- Budget Costs: Consider the cost of medical examination of all the family members in your application.
Possible Difficulties and the Way to Deal with Them
The new rule introduces an initial step that is a planning process. The challenges that may be encountered by the applicants include:
- Cost Burden: The cost of medical checkups of several family members may be high. Pre-save or shop around clinics with good rates.
- Availability of Panel Physicians: There is a possibility that the number of approved physicians in a country or region is limited, which increases the waiting time. Book in advance.
- Medical Admissibility Issues: In case you have a health issue that you are concerned about, an immigration attorney or consultant can advise you on how it can affect your case.
Final Thoughts
The preparation and organization are essential to the Express Entry applicants due to the new requirement of upfront medical exams that will be introduced on August 21, 2025. Although it is one step more, it is meant to make the PR process more efficient and less time-consuming.
Doing your IME as early as possible, budgeting the expenses and making sure that all the paperwork is in place will help you not to be surprised and increase your chances of a successful application.
