Big Change for Express Entry! Upfront Medical Exams Required Starting August 21, 2025

If you are planning to apply for Canadian permanent residence through Express Entry, there’s a major update you can’t afford to miss.

Starting August 21, 2025, Immigration, Refugees and Citizenship Canada (IRCC) now requires upfront medical exams before you can even submit your PR application. This means your Canada Express Entry medical exam must be completed in advance and included in your application package.

This policy change applies to all Express Entry applicants, their spouses or common-law partners and their dependent children, whether accompanying or not
If you’re already in Canada and have had an immigration medical exam (IME) within the last five years, you may be allowed to reuse it. Otherwise, completing an upfront exam is now mandatory.

This move is designed to streamline processing, reduce delays, and expedite final decisions. But it also means applicants need to be more strategic to get the exam done early, budget for the costs, and ensure the validity doesn’t expire before the application is finalised.

Here are some key insights you must look out for:

What Is the Canada Express Entry Medical Exam?

The Canada Express Entry medical exam is a health check-up that ensures applicants are medically admissible to Canada. The Canadian government wants to make sure that newcomers:

• Do not pose a risk to public health or safety
• Do not create an excessive demand on Canada’s healthcare system

Only IRCC-approved panel physicians can perform this exam. You cannot go to your family doctor unless they are listed as an approved panel physician.

What the Medical Exam Includes

The Canada PR medical requirements typically involve:

• A physical examination (height, weight, blood pressure, vision, hearing, heart, lungs, abdomen)
• Blood tests (HIV, syphilis, etc.)
• Chest X-ray (to check for tuberculosis)
• Urine test (for kidney and metabolic issues)
• Vaccination history review (especially for children and young adults)
• Additional tests, if needed, based on age, gender, or pre-existing conditions

The entire exam usually takes 2–3 hours. After completion, the results are sent electronically by the physician directly to IRCC.

Express Entry Medical Exam Requirement — What Has Changed in 2025?

Until recently, applicants often waited until after receiving their Invitation to Apply (ITA) to complete the medical exam. Now, IRCC requires the exam to be done before submission.

Key changes effective August 21, 2025:

• Upfront IME mandatory: All applicants and their dependents must submit proof of an upfront medical exam when applying.
• Prior Applications: The applications which were submitted before August 21, 2025, will not be affected by this change.
• Impact on Non-Express Entry Applications:  This change will only impact Express Entry permanent residence applications; non-Express Entry applications remain unaffected.
• Past IMEs may qualify: If you’re in Canada and have a valid IME from the last five years, you can submit your IME number instead of retaking the test.
• Validity concerns: Medical exams are valid for 12 months only. If your application decision takes longer, you may need to redo it.
• Non-compliance: If you fail to include an upfront exam, your Express Entry application will be considered incomplete.

The new policy aims to simplify the application process, requiring applicants to prepare documents, meet deadlines, and apply early. This change seeks to create a more efficient system, but its success depends on applicants adapting to the new requirements with careful planning and effort.

Who Needs to Take the Medical Exam for Canada Express Entry?

Every applicant looking to apply under Express Entry must complete the medical exam, including:

• Principal applicants (the person applying for PR)
• Spouses or common-law partners
• Dependent children (whether accompanying to Canada or not)

Even if your child or spouse is not joining you in Canada right away, IRCC requires them to undergo the upfront medical exam for Canada PR. This ensures the entire family unit is screened for admissibility.

How to Prepare and Complete Your Medical Exam for Canada Express Entry

Completing your medical exam for Canada Express Entry is simple and easy to go through if you plan ahead.

Step 1: Find an IRCC-Approved Panel Physician

Use the official IRCC panel physician finder to locate doctors authorised to perform the exam in your city or country.

Step 2: Book Your Appointment Early

Since demand may rise due to the new rules, book your exam well in advance and submit your Express Entry application.

Step 3: Bring Required Documents

• Valid passport or government ID
• 4 recent passport-sized photos (if clinic requires)
• Any prescription glasses or contact lenses
• List of current medications
• Past medical reports or test results (if applicable)
• Vaccination records (especially for children)

Step 4: Attend the Exam

The doctor will:

• Ask about your medical history
• Perform physical tests
• Send you for blood and urine tests
• Conduct a chest X-ray

Step 5: Receive Your Document

Upon successfully completing your medical examination, you will be provided with a proof of completion sheet. This document is crucial as it contains your unique Immigrant Medical Examination (IME) number. It is important to keep this sheet safe and ensure its integrity, as you are required to upload it as a mandatory component of your application submission. Without this proof, your application may be considered incomplete.

What Tests Are Included in the Canada Immigration Medical Exam?

The Canada immigration medical exam includes standard health screenings tailored by age:

• All adults (15+): Blood test, urine test, chest X-ray, physical check-up
• Children (5–14 years): Urine test, physical exam (no blood test or X-ray unless necessary)
• Infants (under 5 years): General physical exam only

Additional Tests

If the examining physician identifies any specific health conditions during the medical examination, such as chronic illnesses like diabetes or cardiovascular issues like heart disease, they will likely request additional diagnostic tests. These supplementary tests could include, but are not limited to, blood work, urine analysis, X-rays, electrocardiograms (ECGs), or specialist consultations, depending on the nature of the condition observed. The purpose of these further investigations is to gather a comprehensive and detailed understanding of the applicant’s health status. 

How Long Is a Canada Immigration Medical Exam Valid?

The Canada Express Entry medical exam is valid for 12 months from the date of completion.

If your application is not finalised within this time, you’ll need to reappear for the exam.

Common Scenarios

• If you receive an ITA but delay applying, your exam might expire before approval.
• If IRCC processing is slow, you may be asked for a new exam.

Tip: Time your exam carefully. Ideally, schedule it shortly before submitting your PR application to maximise validity.

Costs and Booking Process for Canada Express Entry Medical Exam

The cost of a Canada PR medical examination varies based on the clinic and its location. This variation is due to different healthcare costs, clinic operational expenses, services included, and any additional tests required.

Typical Cost Range

• Individual adult: CAD 140–$280
• Child: CAD 100–$200
• Family of four: CAD 800–$1,200 total

You must pay the fees directly to the clinic. These fees are not refundable by IRCC.

Booking Process

Step 1: Find an IRCC-Approved Physician (Panel Physician).
Use the official IRCC “Find a panel physician” tool.

Step 2: Schedule Your Appointment.
Contact the clinic directly, stating it’s for an Express Entry immigration medical exam. Confirm documents needed (passport, application number), cost, and payment methods. Book in advance due to increased demand.

Step 3: Understand Payment Procedures.
Payment is usually due at booking or visit. Confirm accepted methods (credit/debit/cash) and total cost. Request a detailed receipt.

Step 4: Complete Exam & Get Proof.
The exam includes physical checks, history review, blood/urine tests, and X-rays. Be honest and follow instructions. You’ll receive an Immigration Medical Exam (IME) number and an uplift/information sheet as proof. Results are electronically sent to IRCC.

Understanding Medical Inadmissibility and Its Impact on Your Canada PR Application

Not every applicant will successfully pass the required medical examination. Immigration, Refugees and Citizenship Canada (IRCC) reserves the right to refuse applications if an applicant is determined to be medically inadmissible. This decision is made based on specific criteria outlined by Canadian immigration law, primarily to ensure public health and safety, and to avoid excessive demand on Canada’s health and social services. 

Grounds for Medical Inadmissibility

1. Danger to public health – contagious diseases like untreated TB or active syphilis
2. Danger to public safety – serious psychiatric conditions or violent behaviour
3. Excessive demand on health or social services – if treatment costs exceed a threshold (approx. CAD 135,810 over 5 years in 2025)

Implications of the New Policy

• Generally, individuals with controlled chronic conditions such as diabetes or hypertension are still eligible.
• Applicants with complex medical requirements might be asked to provide further documentation.

A medical mitigation plan can be submitted by some applicants to demonstrate that they will not strain the healthcare system.

Conclusion

The new upfront medical exam requirement for Express Entry applications is one of the most significant changes in Canada’s immigration system in recent years.

From August 21, 2025, all applicants and their dependents must complete their Canada Express Entry medical exam before applying for PR. While this adds an extra step early in the process, it helps IRCC process applications faster and avoids delays later.

At VisaAxis, our immigration experts help you stay compliant with IRCC’s latest requirements, guide you through the medical exam process, and maximize your chances of a successful PR application.

Book your consultation today with VisaAxis and move one step closer to Canada!

FAQs 

1. Can I use a previous medical exam for my Canada PR application?
   Yes, if your medical exam was completed in Canada within the past five years and remains valid. You’ll need to provide your unique IME number when submitting your PR application to IRCC.
2. What documents do I need for the immigration medical exam?
   You must bring your valid passport or government ID, recent passport-sized photos (if required), past medical reports, vaccination records, a list of prescriptions, and any glasses or contact lenses to your appointment with the panel physician.
3. Can I choose my family doctor for the medical exam?
   No, only IRCC-approved panel physicians can conduct immigration medical exams. Your family doctor cannot perform it unless they are on IRCC’s authorised panel list. Use the IRCC panel physician finder to locate one.
4. How do I get my medical exam results and upload proof?
   You won’t receive detailed results directly. Instead, the panel physician submits them electronically to IRCC. You’ll receive a document with your IME number, which you must upload as proof with your Canada PR application for Express Entry.
5. Will the upfront medical exam affect my CRS score or invitation chance?
   No, the medical exam does not impact your CRS score or chances of receiving an Invitation to Apply (ITA). It is simply a mandatory requirement to ensure medical admissibility before your Express Entry PR application is processed.