Immigration, Refugees and Citizenship Canada (IRCC) will soon require all applicants for permanent residence under Express Entry to complete their immigration medical exam (IME) before submitting their application. The change, which takes effect August 21, 2025, will not apply to applications submitted before that date and does not affect non–Express Entry PR streams.
Until now, Express Entry applicants submitted their application first and then waited for IRCC’s instructions to complete the exam. Under the new rules, medicals must be done in advance with an IRCC-approved panel physician. The exams typically cost between $140 and $280 per person, with applicants covering all related expenses, including specialist visits or additional tests.
Medical admissibility remains a critical requirement for the principal applicant and all family members, whether or not they are accompanying them to Canada. Inadmissibility can be based on public health risks — such as certain infectious diseases — or “excessive demand” on health services, defined as costs exceeding $27,162 annually. Demonstrating that chronic conditions are stable and well-managed can help mitigate admissibility concerns.
An IME usually includes a medical history review, full-body physical exam, X-rays, blood and urine tests, mental health assessments, and a vaccination record check. Applicants in Canada who completed an IME in the last five years for a different immigration process may submit their previous IME number, though IRCC may still request a new exam if results cannot be reused.
Full details, including the list of approved physicians worldwide, are available on IRCC’s website.