Immigration, Refugees and Citizenship Canada (IRCC) has introduced a new requirement for Express Entry applicants. Starting August 21, 2025, individuals applying for permanent residence through Express Entry must complete an upfront medical exam before submitting their application.
Previously, applicants would file their PR application first and then wait for IRCC to issue medical exam instructions. This change applies only to Express Entry applications submitted on or after August 21, 2025. Non-Express Entry permanent residence programs will not be impacted.
Medical Admissibility Requirements
All principal applicants and their family members—whether accompanying or not—must be deemed medically admissible to Canada.
A person may be found medically inadmissible if:
- Their condition is expected to cause an excessive demand on Canadian healthcare services (defined as costs exceeding three times the national average, or $27,162 per year).
- Their condition poses a risk to public health, such as certain infectious diseases.
Applicants with controlled chronic conditions, such as stable diabetes, may reduce the risk of inadmissibility by showing evidence of ongoing treatment and management.
About Immigration Medical Exams (IMEs)
All medical exams must be completed with an IRCC-approved panel physician. Applicants can find the list of approved doctors on IRCC’s website and book an appointment directly.
Typical costs: $140 to $280 per person.
Applicants must also cover any additional expenses, including:
- Fees for the physician or radiologist,
- Special tests, treatments, or investigations, and
- Specialist consultations.
What an IME may include:
- Review of medical history (previous surgeries, treatments, chronic conditions),
- Full physical exam (eyes, heart, lungs, etc.),
- X-rays (e.g., chest X-ray for tuberculosis),
- Blood and urine tests,
- Mental health assessment(s), and
- Immunization record verification.
What to bring:
- Passport or national ID,
- Four recent photographs,
- A list of current medications,
- Any past medical reports/results,
- Proof of prior vaccinations.
Re-using a Previous IME
Applicants already in Canada who have completed an IME within the last five years (for a work or study permit) can submit their IME number or unique medical identifier with their PR application.
If they were previously assessed as low risk or no risk to public health, they may not need a new exam. However, if IRCC determines that the prior results cannot be reused, applicants will be notified to undergo a fresh IME.
