Immigration, Refugees, and Citizenship Canada (IRCC) is set to reinstate a long-standing requirement: applicants seeking permanent residency through the Express Entry system must now complete an immigration medical examination before submitting their application. The policy, effective August 21, 2025, marks a reversal of the more recent practice, established in October 2023, which allowed applicants to submit before completing the exam.
Why the Change Matters
Under the previous process, applicants awaited IRCC-issued instructions to complete their medical examination after submitting their Express Entry application. This often led to processing delays, as medical results were a bottleneck. Launching the exam upfront ensures that medical findings are already in hand when the application is being reviewed, streamlining the PR process.
Who Must Now Complete the Exam in Advance
- Express Entry applicants, including both principal applicants and accompanying (or non-accompanying) family members, must complete an Immigration Medical Exam (IME) before submitting their permanent residence application.
- This requirement applies only to Express Entry candidates; other permanent residence streams remain unaffected and continue the previous model of obtaining medical instructions after application submission.
Exception: Applicants with a Recent IME
If you completed an IME within the past five years and received a low-risk or no-risk assessment, you may be able to reuse that medical result. Simply include your IME number (medical identifier) in your new application. IRCC will determine if the previous exam is still valid or if a fresh one is necessary.
What the Step-by-Step Process Looks Like Now
- Obtain Invitation to Apply (ITA): Under Express Entry, you first receive an ITA based on your Comprehensive Ranking System (CRS) score.
- Schedule and complete the IME: Before submitting your permanent residence application, you must book with an IRCC-approved panel physician and complete the medical exam.
- Include IME result in your application: Upload the medical results or provide the IME number if you’re reusing a prior exam.
- Submit your application: With medical clearance already in place, IRCC review can proceed without pause.
What to Bring and Expect at the Exam
- Identification: Passport or another IRCC-approved ID
- Medical history & documentation: Current medications, past medical reports, and vaccination records (e.g., COVID-19, measles, polio), though not mandatory, are strongly encouraged.
- Tests: Standard IMEs include medical history, physical exam, chest X-rays, lab work, and possibly specialist exams if needed.
- Fees: Costs typically range between CAD 140–280 per person, excluding any additional charges for vaccines, specialists, or treatments.
Why This Policy Shift Is Meaningful
- Improved efficiency: With health assessments completed in advance, IRCC can reduce backlog and speed up final decisions.
- Transparency and preparedness: Applicants now know their medical admissibility status upfront, reducing the risk of surprises later in the process.
- Harmonized planning: Particularly during high-demand periods, securing early IME appointments avoids delays caused by exam backlogs.
Final Thoughts
Starting August 21, 2025, Express Entry applicants must take the medical exam earlier in their journey, making IRCC’s decision both a logistical adjustment and a strategic move to improve application flow. While it introduces an additional pre-submission step, the policy enhances predictability and supports a more efficient processing timeline.
