New Medical Exam Rules for Express Entry Permanent Residence Applications

Immigration, Refugees and Citizenship Canada (IRCC) has announced a new requirement for Express Entry applicants. Starting August 21, 2025, anyone applying for permanent residence through Express Entry will need to complete their immigration medical exam (IME) upfront before submitting their application.

What’s Changing?

Until now, Express Entry applicants could submit their permanent residence application first and then wait for IRCC to send instructions for the medical exam. From August 21, 2025, the medical exam must be completed before the application is submitted.

This change applies only to Express Entry permanent residence applications submitted on or after August 21, 2025.

• Applications submitted before this date will follow the old process.
• Other permanent residence streams (non-Express Entry) are not affected by this change.
  
  

Medical Admissibility Requirements

To be approved for permanent residence, the main applicant and their family members must be medically admissible to Canada—even if the family members are not coming to Canada.

A person may be found medically inadmissible if:

• Their health condition is expected to place excessive demand on Canada’s health or social services (costing more than $27,162 per year).
• Their condition poses a risk to public health, such as certain infectious diseases.

If you have a chronic health condition (like diabetes), showing that it is stable and well-managed can reduce the risk of inadmissibility.

About the Immigration Medical Exam (IME)

An IME must be done by an IRCC-approved panel physician. You can find the list of approved doctors on the IRCC website by selecting your country or territory.

Typical costs: $140–$280 per person. Applicants pay for all related expenses, including:

• Doctor or radiologist fees
• Special tests or treatments
• Specialist consultations
  
  

An IME may include:

• Review of past medical history
• Full physical examination
• X-rays (e.g., chest x-ray for Tuberculosis)
• Blood and urine tests
• Mental health assessment
• Immunization record check
  
  

What to bring to your IME:

• A list of current medications
• Medical reports for any existing conditions
• Proof of past vaccinations
• Identification (passport or national ID card)
• Four recent photographs
  
  

Reusing a Previous Medical Exam

If you are in Canada and have completed an IME within the last five years (e.g., for a work or study permit), you can provide your IME number or unique medical identifier in your PR application. If IRCC decides the previous results are not valid, they will instruct you to complete a new medical exam.