Starting August 21, 2025, anyone applying for permanent residence through Canada’s Express Entry system will need to complete their immigration medical exam before submitting their application.
This is a major shift.
Medical Exams for Express Entry—What’s Changing?
Until now, you’d apply first, then wait for instructions from IRCC on when and where to do your medical. That’s changing. If you’re planning to submit an Express Entry PR application on or after that date, the medical exam needs to be done and ready up front.
This medical test requirement applies only to Express Entry routes. Applications submitted before August 21 aren’t affected. Neither are other PR streams like family sponsorships or refugee claims.
Why This Change Matters
IRCC is tightening the timeline to speed up the decision-making process. Having medical results on hand from the start means fewer delays and potentially faster processing. But it also means one more thing to check off before applying and one more expense to plan for.
Who Needs a Medical Exam?
If you’re the main applicant under Express Entry, and especially if you’re bringing family, you all need to complete an approved Immigration Medical Exam (IME), even if your dependents won’t move to Canada right away.
Here’s the rule: every person included in the application must be medically admissible.
Who’s Exempt?
Not many. But if you’re applying from inside Canada and you’ve already had an IRCC-approved medical exam in the past five years for a study or work permit, you might not need to do another one.
You’ll need to submit your previous IME number or medical identifier. IRCC will then decide if your earlier exam still qualifies. If not, they’ll let you know that you need a fresh one.
Reasons You Could Be Denied on Medical Grounds
Learn which medical conditions could lead to PR refusal in Canada due to public health risks or excessive healthcare costs. There are two big red flags:
1. Public Health Risks
This includes certain infectious diseases, think untreated tuberculosis or anything that might threaten Canada’s public health.
2. Excessive Demand on the Healthcare System
If your condition is expected to cost more than three times Canada’s per capita annual health spending, currently set at $27,162, you could be denied.
This includes treatments, meds, or long-term care. But not all chronic conditions lead to rejection. For example, someone with well-managed diabetes who follows treatment protocols may still be admitted.
What Happens During the Medical Exam?
You can’t just walk into any clinic. You’ll need to book an appointment with a panel physician approved by IRCC. There’s a list by country on the IRCC website.
Expect the following:
- Review of your medical history, past surgeries, and ongoing conditions
- A full physical exam-heart, lungs, eyes, etc.
- Chest x-ray (often mandatory for TB screening)
- Blood and urine tests
- Mental health screening
- Verification of vaccination records
Bring with you:
- Government-issued ID (passport is best)
- Previous medical records and test results (if any)
- A list of medications you’re currently taking
- Vaccination proof
- 4 recent passport-sized photos
How Much Does It Cost?
Fees vary by country and clinic, but most exams fall between $140 and $280 CAD per person. That includes the doctor’s fee, lab work, x-rays, and any necessary referrals to specialists.
Keep in mind, this is an out-of-pocket cost, not something IRCC reimburses.
How to Book Your Exam
- Visit the IRCC Panel Physician list
- Choose your country and city
- Contact a panel physician to schedule your IME
- Complete the exam before submitting your PR application
Final Thought
This new upfront medical exam rule means Express Entry applicants have to be even more organized. It’s one more step to manage early, but it also means fewer surprises down the road.
If you’re planning to apply after August 21, make the IME part of your early checklist. Don’t wait until the last minute.
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