IRCC Announces New Medical Exam Requirements for Express Entry Applicants

Immigration, Refugees and Citizenship Canada (IRCC) has announced that, effective August 21, 2025, applicants applying for permanent residence through the Express Entry system must complete an upfront Immigration Medical Exam (IME) before submitting their application.

Written & reviewed by Keshav Sharma, RCIC #R530203, Founder, ELAAR Immigration Consulting Inc.Last reviewed: October 20264 min read

Previously, Express Entry candidates submitted their application and waited for IRCC to issue medical exam instructions later in the process.

Applications submitted before August 21, 2025 will continue under the current process and will not be affected. This change also does not apply to non-Express Entry permanent residence streams.

About New Medical Exam Requirements

According to Canadian immigration regulations, the main applicant and all family members, regardless of whether they are accompanying, must meet medical admissibility requirements for Canada.

Medical inadmissibility can result from:

• Excessive demand on health services: If treatment costs exceed three times the national average per capita ($27,162/year)

• Public health risks: Such as active tuberculosis or other contagious conditions

Applicants with stable and controlled chronic conditions, such as diabetes, can reduce their risk of inadmissibility by providing comprehensive medical records showing effective management.

Immigration Medical Exam (IME) Process

IME must be conducted by a panel physician. These are doctors specifically approved and trained by IRCC to follow strict procedures and report results directly to the government. This ensures the integrity and consistency of all medical exams.

What to Expect During Your IME

The IME is a comprehensive health check designed to confirm you meet Canada’s health admissibility standards. Here’s what the exam typically involves:

• Medical History Review: The panel physician will discuss your medical background, including any past surgeries, hospitalizations, treatments, or chronic conditions.
• Physical Examination: A complete check-up of your eyes, ears, heart, lungs, and abdomen to evaluate your overall health.
• Chest X-ray: This is a standard procedure, primarily used to screen for tuberculosis and other lung conditions.
• Laboratory Tests: Blood and urine samples may be taken to check for infections, diseases, or other health issues.
• Mental Health Assessment: A brief evaluation to identify any significant mental health concerns.
• Immunization Record Check: Your vaccination history will be reviewed to ensure it aligns with Canadian public health requirements.

Read more: Medical Exam for Express Entry

Costs and Fees for IME

The cost of an IME generally ranges from $140 to $280 per person. Keep in mind that this is just the base fee. You are responsible for paying all costs associated with the exam, including:

• Fees for any additional tests the doctor orders.
• Costs for referrals to specialists.
• Treatment fees, if recommended.

All payments are made directly to the clinic at the time of your appointment.

Preparing for Your Appointment

To prevent delays and ensure a seamless process, gather the following documents and items before your appointment:

• Valid Passport or National Identity Card: Essential for identity verification.
• Four Recent Photographs: Check with the specific clinic for their size and format requirements.
• List of Medications: A complete list of all current medications you are taking.
• Medical Reports: Any medical records, test results, or reports related to existing health conditions.
• Vaccination Records: Proof of your past immunizations.

Previous IMEs

If you completed an IME in the last 5 years (for a work or study permit), include the IME number with your PR application. IRCC will confirm if your prior exam is valid or instruct you to retake the exam.

Need Expert Guidance?

From August 21, 2025, failure to complete and submit an upfront IME at the time of application will result in an incomplete Express Entry submission. This change underscores the importance of preparing medical documentation early to avoid delays or refusals.

As IRCC continues to adjust application requirements, early preparation is essential for a smooth immigration process. For detailed guidance on the new medical exam rules and other Express Entry requirements, please feel free to contact us for a consultation.