On this page you will find:
- Overview of the August 21, 2025 Express Entry rule change
- Medical exam process for other applicants
- Extended public policy for in-Canada applicants
- Who must take a medical exam
- What to bring and expected costs
Canada Updates Medical Exam Requirements for Express Entry
Immigration, Refugees and Citizenship Canada (IRCC) has changed when Express Entry applicants must complete their immigration medical exam.
As of August 21, 2025, anyone applying under Express Entry must complete an upfront medical exam before submitting their permanent residence application. This replaces the previous process, where applicants waited for IRCC instructions before taking the exam.
Applications submitted before this date are not affected, and non-Express Entry permanent residence applications will continue under the existing procedure.
Medical Exam Process for Other Applicants
For other types of permanent residence applications, IRCC will send instructions after you submit your complete application. You must then complete the medical exam within 30 days.
If you are making a refugee claim at a port of entry, you will be instructed to take a medical exam within 30 days.
In-Canada Applicants and Temporary Policy Extension
For applicants already in Canada, the temporary public policy for immigration medical exams currently expires on October 5, 2029. If you completed an exam within the last five years, you can use the same results by including your previous medical identifier number in your new application.
Who Must Take the Medical Exam
If you apply for permanent residence, you and your family members must take a medical exam, even if they are not accompanying you. IRCC may request a standard or streamlined exam depending on the situation, but applicants cannot choose the type themselves.
Who Can Perform the Exam
Only a doctor from IRCC’s list of panel physicians can perform your medical exam. Your regular family doctor cannot. The panel physician will conduct the exam, but IRCC will make the final decision.
What to Bring to Your Medical Exam
Applicants must bring valid identification (such as a passport), glasses or contact lenses if worn, medical reports for existing conditions, a list of current medications, and proof of vaccination if available. You may also need photographs if the physician does not use eMedical.
Costs and Possible Exemptions
You must pay for all exam fees, tests, and specialist referrals. Refugees and asylum seekers may be exempt from these costs. If you cannot complete the exam due to exceptional circumstances, you should submit a letter explaining why.
FAQ
What is an upfront medical exam for Express Entry?
An upfront medical exam is a medical check completed before you submit your Express Entry application. From August 21, 2025, it is mandatory for all Express Entry applicants.
Do these new rules apply to all permanent residence applicants?
No. The upfront medical exam rule applies only to Express Entry applications submitted on or after August 21, 2025. Other programs follow the existing process.
Can I use my old medical exam results?
If you are in Canada and completed an immigration medical exam within the last five years, you can use those results by providing your previous IME number.
Who can perform my immigration medical exam?
Only a panel physician approved by IRCC can conduct your medical exam. You cannot use your family doctor unless they are on the panel physician list.
What happens if I cannot complete my medical exam?
If you cannot take your exam due to exceptional circumstances, submit a written explanation to IRCC. They will review your request before making a decision.
