New Medical Exam Requirements for Express Entry Permanent Residence Applications

Vikrant Gungash
Aug 16
3 min read

By Vikrant Singh, August 15 2025

Starting August 21, 2025, Immigration, Refugees and Citizenship Canada (IRCC) will require upfront medical exams from all applicants submitting a permanent residence application under the Express Entry system.

This change marks a shift from the previous process, where applicants would submit their permanent residence (PR) application first and then wait for IRCC to issue instructions for medical exams.

Importantly, the new rule applies only to Express Entry PR applications submitted on or after August 21, 2025. Applications already in process, as well as other permanent residence streams outside of Express Entry, will not be affected.

Why Medical Exams Are Required

All permanent residence applicants—and their family members, whether or not they are accompanying them to Canada—must be found medically admissible.

Medical admissibility is assessed to ensure newcomers will not:

Pose a risk to public health (e.g., carrying infectious diseases).
Place an excessive demand on Canada’s healthcare system, defined as medical or social service costs exceeding $27,162 per year (three times the Canadian average).

Applicants with chronic conditions such as diabetes can often still qualify, provided they show their condition is stable, controlled, and under treatment.

What an Immigration Medical Exam (IME) Involves

Immigration medical exams must be completed by an IRCC-approved panel physician. Applicants can find panel physicians listed on IRCC’s official website by country or territory and must book directly.

Typical costs range from $140 to $280 per person, plus any extra fees for tests or specialist referrals.

An IME usually includes:

Review of past medical history (e.g., surgeries, illnesses, treatments).
Full-body physical exam (eyes, heart, lungs, etc.).
Chest X-rays (commonly to check for tuberculosis).
Blood and urine tests.
Mental health evaluation.
Review of vaccination records.

What to bring:

Valid ID (passport or national identity card).
Four recent photographs.
Current prescriptions or a list of medications.
Medical reports for any chronic or existing conditions.
Proof of past vaccinations.

Previous Medical Exams

Applicants already in Canada who underwent an IME within the last five years—for example, during a work permit or study permit application—may not need to repeat it. If eligible, they can provide their IME number or unique medical identifier with their PR application.

IRCC will review whether past results are still valid. If not, applicants will be notified to complete a new exam.

Key Takeaway

From August 21, 2025, Express Entry applicants must undergo and submit their immigration medical exam results upfront when applying for permanent residence.

This update is designed to streamline application processing but adds an extra preparation step for candidates. Prospective applicants should plan ahead by scheduling their IMEs early, budgeting for the additional cost, and gathering the necessary documents before submitting their PR application.

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